Quelle place pour l'hémiarthroplastie en urgence ou en secondaire pour fracture de l'extrémité distale du radius du sujet âgé autonome ?

The authors report their experience with wrist hemiarthroplasty for acute irreparable distal radius fractures in independent elderly patients (12 women, mean age 76 years) and following failed initial treatment in the same population (5 women, mean age 75 years). The first 11 cases have a mean follow-up of 30 months. No complications requiring implant removal were reported. At follow-up, the mean VAS for pain was 1/10, the mean flexion-extension arc was 60°, the Lyon Wrist score was 73 % and the PRWE (Patient-Related Wrist Evaluation) was 22 points. The five patients who had secondary procedures and were reviewed at mean of 16 months' follow-up did not require implant removal but there was one complete forearm rotational ankylosis with ossification. At follow-up, the mean VAS for pain was 3/10, the mean flexion-extension arc was 56°, the Lyon Wrist score was 65 % and the PRWE was 45 points. The authors believe that hemiarthroplasty is a useful salvage procedure for irreparable wrist fractures in the emergency room and after failed initial treatment in active elderly patients.