The Resurgence of Dorsal Plating for Distal Radius Fractures in Malaysia: An Epidemiological Study at a Tertiary Hand...

This study aimed to define the contemporary epidemiological profile of adult distal radius fractures (DRFs) at a dedicated Hand and Microsurgery Centre in Malaysia.

A retrospective cross-sectional study included 387 adult patients with nonpathological DRFs presenting to the Hospital Selayang, Malaysia, over a 24-month period (January 2023-December 2024). Demographic variables, injury mechanisms, fracture classifications (OTA and Frykman), and treatment modalities were analysed. Between-gender comparisons were performed using Mann-Whitney and chi-square tests.

The mean age was 52.8 ± 19.8 years, with a bimodal distribution peaking at 30-40 years and 65-75 years. Males predominated overall (n = 208, 53.7%), but with a striking age disparity: median age for females was 63 years compared to 39 years for males (p < 0.001). Fall on an outstretched hand (FOOSH) was the predominant mechanism (n = 233, 60.3%). Notably, fragility fractures constituted nearly half of all DRFs (n = 176, 45.5%), occurring predominantly in elderly females (n = 128, 72.7%) with a mean age of 70.1 ± 9.4 years. Conservative management with casting was employed in 75.7% (n = 293) of patients. Among surgically treated cases, volar rim plating (n = 27, 7%) and variable-angle locking compression plating (n = 21, 5.4%) were the most common.  Discussion: This study confirms a bimodal age distribution for DRFs in Malaysia but reveals an alarmingly high proportion of fragility fractures (n = 176, 45.5%), exceeding rates reported in Western populations. These findings mandate urgent implementation of fracture liaison services to address the secondary prevention gap. The predominance of conservative management, even for complex fractures, reflects regional practice patterns that warrant prospective evaluation against functional outcomes.