333 Management of Distal Radius Fractures During The COVID-19 Crisis

East, J; Tahir, M; Bose, D; Quraishi, H

INTRODUCTION: Distal radius fractures are common. Treatment depends on a multitude of factors including the pattern / displacement of the fracture, patient age, pre-morbid function, and surgeon preference. We aim to investigate the effect of the pandemic on the management and short-term outcomes of patients with DRF’s. METHOD: Retrospective review of all adult DRF’s two months before and after BOA released emergency standards on trauma management. The primary outcome measure was the proportion of patients managed non-operatively before and during COVID-19. Data extracted: demographics, comorbidities, cognitive baseline, treatment, and follow-up. Radiographs were reviewed for displacement [dorsal tilt (>10(o)), ulnar variance (>3mm), intra-articular step (>2mm)]. RESULTS: Pre-COVID (n = 29), COVID (n = 35). Characteristics were comparable in terms of median age (66 and 72 years, p = 0.41), %aged ≤65 (48% and 37%, p = 0.37), dominant side fracture (36% and 40%, p = 0.52), presence ≥ 2 co-morbidities (41% and 43%, p = 0.91). More patients were managed non-operatively during COVID (86% vs. 69%, p = 0.11), 2 of whom had unstable fracture pattern and developed malunion, compared to none in pre-COVID period. CONCLUSIONS: Management of DRF’s remains a controversial topic, particularly in age <65 years. Long term follow up of patients with significant fracture displacement managed conservatively during COVID pandemic could help guide future practice.