Posttraumatic arthritis and functional outcomes of nonoperatively treated distal radius fractures after 3 years

Recent studies have shown that distal radius fractures (DRFs) in elderly patients can be treated nonoperatively with good functional results after 1 year. However, scientific evidence regarding longer follow-up to assess posttraumatic arthritis (PA), complications, and functional outcomes is scarce. This prospective case series aimed to evaluate these outcomes in a cohort of patients ≥ 65-year-old with nonoperatively treated DRFs after a minimum of 3 years. The primary outcome was PA. Secondary outcomes were complications, Quick Disabilities of the Arm, Shoulder and Hand Outcome Measure (QuickDASH), Patient-Rated Wrist/Hand Evaluation (PRWHE), pain, range of motion and grip strength. The full data of 32 patients with a mean follow-up of 3.3 years were available: 10/32 patients had radiological signs of PA, but only 2 of these patients reported pain. A total of 11/32 fractures healed in malunion (> 10° dorsal angulation). There was no significant difference in QuickDASH or PRWHE from 1 year to the latest follow-up after more than 3 years. This study thus adds to the literature stating that radiological signs, including PA and malunion, do not necessarily result in symptoms. Moreover, it underpins that nonoperative treatment of these patients results in good functional outcomes after 1 and 3 years.