Ulus Travma Acil Cerrahi Derg. 2024; 30(11): 828-834 | DOI: 10.14744/tjtes.2024.87426

Radiological comparison of two immobilization methods in the non-surgical treatment of distal radius fractures in the elderly: Single sugar-tong splint shows similar efficacy to long-arm cast

Ali Engin Daþtan¹, Arman Vahabi¹, Kadir Yaðmuroðlu¹, Yusuf Kerem Limon², Aytek Hüseyin Çeliksöz³, Okan Tezgel⁴, Levent Kucuk⁵, Erhan Coskunol¹, Kemal Aktuglu^1
1Department of Orthopedics and Traumatology, Ege University University School of Medicine, Bornova, Izmir-Türkiye
²Department of Radiology, Akdeniz University School of Medicine, Antalya-Türkiye
³Department of Orthopedics and Traumatology, Eskisehir City Hospital, Eskisehir-Türkiye
⁴Department of Orthopedics and Traumatology, Medipol Bahçelievler Hospital, Istanbul-Türkiye
⁵Department of Orthopedics and Traumatology, Medicana International Hospital, Izmir-Türkiye

BACKGROUND: This study aims to compare the effectiveness of the long-arm cast (LAC) and the single sugar-tong splint (SSTS) in the non-operative treatment of distal radius fractures in the geriatric population.
METHODS: Patients consulted at the Orthopedics and Traumatology Department within the Emergency Department (ED) were reviewed through the electronic archives of a tertiary university hospital over a five-year period. The study included patients aged 65 years and older with a distal radius fracture who required reduction, had successful closed reduction, and had at least six weeks of X-ray follow-up. The patients were divided into two groups based on the immobilization method: the SSTS group (n=88) and the LAC group (n=31). The patients' radiographs taken after reduction in the ED, as well as at the 1st, 2nd, 4th, and 6th weeks, were evaluated. Radial height, radial inclination, volar tilt, and ulnar variance were measured on the radiographs at each visit. The delta value was calculated by subtracting the measurement on the first post-reduction radiograph from the measurement taken at the sixth week. The data obtained were then compared between the two groups.
RESULTS: A total of 119 patients (93 females, 26 males, mean age: 72.9±7.3 years; range, 65 to 90 years) were included. The mean age was 74.6±7.6 in Group 1 and 72.3±7.2 in Group 2 (p=0.135). Group 1 consisted of 26 females and 5 males; Group 2 included 67 females and 21 males (p=0.52). Statistically significant differences were observed in post-reduction volar tilt (p=0.005), first week volar tilt (p=0.020), post-reduction ulnar variance (p=0.044), first week ulnar variance (p=0.037), and second week ulnar variance (p=0.027) between the groups. No statistically significant differences were detected in other radiological parameters, including delta values. Two patients in Group 1 and seven patients in Group 2 required secondary intervention (p=1).
CONCLUSION: In the non-operative management of geriatric distal radius fractures, the SSTS is an immobilization technique that is as effective as the LAC.

Keywords: Geriatric distal radius fracture, long-arm cast; single sugar-tong splint.

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Yaþlýlarda distal radius kýrýklarýnýn konservatif tedavisinde iki immobilizasyon yönteminin radyolojik karþýlaþtýrýlmasý: Tekli þeker maþasý ateli ile uzun kol alçýsýnýn etkinliði benzerdir

Ali Engin Daþtan¹, Arman Vahabi¹, Kadir Yaðmuroðlu¹, Yusuf Kerem Limon², Aytek Hüseyin Çeliksöz³, Okan Tezgel⁴, Levent Kucuk⁵, Erhan Coskunol¹, Kemal Aktuglu^1
1Ege Üniversitesi Týp Fakültesi Hastanesi, Ortopedi ve Travmatoloji Anabilim Dalý, Ýzmir, Türkiye
²Akdeniz Üniversitesi Týp Fakültesi, Radyoloji Anabilim Dalý, Antalya, Türkiye
³Eskiþehir Þehir Hastanesi, Ortopedi ve Travmatoloji Kliniði, Eskisehir, Türkiye
⁴Medipol Bahçelievler Hastanesi, Ortopedi ve Travmatoloji Kliniði, Istanbul, Türkiye
⁵Medicana International Hastanesi, Ortopedi ve Travmatoloji Kliniði, Izmir, Türkiye

AMAÇ: Bu çalýþmada geriatrik popülasyonda distal radius kýrýklarýnýn cerrahiolmayan tedavisinde uzun kol alçýsý (UKA) ve tekli þeker maþasý atelinin (TÞMA) etkinliðini karþýlaþtýrmak amaçlandý.
GEREÇ VE YÖNTEM: Acil servis (AS) ortopedi ve travmatoloji bölümünde konsülte edilen hastalar, beþ yýllýk bir süre boyunca üçüncü basamak bir üniversite hastanesinin elektronik arþivleri kullanýlarak incelendi. Çalýþmaya, redüksiyon gerektiren, baþarýlý kapalý redüksiyon geçiren ve en az altý hafta röntgen takibi olan 65 yaþ ve üzeri distal radius kýrýðý olan hastalar dahil edildi. Hastalar immobilizasyon yöntemine göre iki gruba ayrýldý: TÞMA grubu (n=88) ve UKA grubu (n=31). Hastalarýn AS'de redüksiyondan sonra ve 1., 2., 4. ve 6. haftalarda çekilen radyografileri deðerlendirildi. Her ziyarette radyografilerde radyal yükseklik, radyal eðim, volar eðim ve ulnar varyans ölçüldü. Delta deðeri, altýncý haftada alýnan ölçümden ilk redüksiyon sonrasý radyografideki ölçüm çýkarýlarak hesaplandý. Elde edilen veriler daha sonra iki grup arasýnda karþýlaþtýrýldý.
BULGULAR: Toplam 119 hasta (93 kadýn, 26 erkek; ortalama yaþ: 72.9±7.3 yýl; aralýk, 65 ila 90 yýl) dahil edildi. Ortalama yaþ grup 1'de 74.6∓7.6 ve grup 2'de 72.3∓7.2 idi (p=0.135). Grup 1 26 kadýn ve 5 erkekten oluþuyordu; grup 2 ise 67 kadýn, 21 erkekti (p=0.52). Redüksiyon sonrasý volar tilt (p=0.005), 1. hafta volar tilt (p=0.020), redüksiyon sonrasý ulnar varyans (p=0.044), 1. hafta ulnar varyans (p=0.037), 2. hafta ulnar varyans (p=0.027) gruplar arasýnda istatistiksel olarak anlamlý fark gösterdi. Delta deðerleri de dahil olmak üzere diðer radyolojik parametrelerde istatistiksel olarak anlamlý bir fark saptanmadý. Grup 1'deki iki hastaya ve grup 2'deki 7 hastaya tekrar müdahale gerekmiþti (p=1).
SONUÇ: Geriatrik distal radius kýrýklarýnýn konservatif tedavisinde TÞMA, UKA kadar etkili bir immobilizasyon tekniðidir.

Anahtar Kelimeler: Geriatrik distal radius kýrýðý, uzun kol alçýsý; sugar tong ateli.

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