gms | German Medical Science

Objectives/Interrogation: Distal radius fractures are common, potentially disabling injuries. Much of the research done has concentrated on low energy injuries in older patients. In contrast, less has been studied about this injury in young adults, or due to high energy injuries alone. For the latter, work has largely focused on the surgical management of these injuries.

In our practice, we perceived differences between the typical older patient with low energy distal radius fractures, and the less common high energy trauma fractures. These differences included patient and injury characteristics, as well as treatment choices. We performed this study to determine if such differences really existed. If so, the findings would have implications for injury prevention, diagnosis, treatment, and eventual outcome.

Methods: Patients with distal radius fractures who were treated at our institution, were obtained from our database. This included demographic data, injury mechanism, fracture classification (using the AO classification), associated injuries, work-related injury, and associated distal ulna fractures, treatment types, complications and outcomes.

Results and Conclusions: The high velocity distal radius fracture (HVDRF) patient was on average 20 years younger (95% CI 17.1 to 22.9 years), and likely male (77.8% vs 27.3% in the low velocity group, p < 0.05). These group of patients were also more likely to have sustained work related injuries.

Falls, sporting injuries and motor vehicular accidents were the most common causes of high velocity injuries. From falls, 17/41 (41%) were due to a fall from height greater than 2m.

There were also significant differences in the fracture patterns and associated injuries in these patients. All the bilateral fractures came from the high velocity injury group (p < 0.05). Based on the AO classification, the HV group had a much high incidence of AO B type fractures compared to the LV group, were more likely to have associated injuries, including an concomitant ipsilateral arm injury.

The high velocity injuries represent a substantial patient group that has different patient and injury profiles compared to the better-studied osteoporotic fractures. The result of these contrasting profiles is a different treatment profile between the two groups. In order to better understand, treat, and prevent them, HVDRF injuries deserves to be considered a distinct entity, much as paediatric distal radius fractures are now considered separately from osteoporotic adult fractures.