Operative Treatment Is Associated With Better Radiographic Alignment but Similar Patient-Reported Outcomes After...

Area of Science:

• Orthopedic surgery
• Geriatric medicine
• Musculoskeletal research

Background:

• Distal radius fractures are highly prevalent in women aged 65 and older.
• Optimal treatment strategies for these fractures remain a subject of ongoing clinical debate.
• Low-energy fractures in this demographic often present unique management challenges.

Purpose of the Study:

• To compare patient-reported outcomes and radiographic alignment following conservative treatment, volar locking plate fixation, and external fixation for low-energy distal radius fractures.
• To evaluate functional recovery and pain levels in elderly women based on fracture treatment.
• To assess the impact of different fixation methods on achieving optimal bone alignment.

Main Methods:

• Retrospective cohort study of 134 women aged ≥65 years with low-energy distal radius fractures.
• Comparison of three treatment groups: conservative management, open reduction and internal fixation (ORIF) with volar locking plates, and external fixation.
• Primary outcome: Patient-Reported Wrist Evaluation (PRWE) score at ≥12 months. Secondary outcomes included QuickDASH, range of motion, grip strength, and radiographic parameters.

Main Results:

• No significant differences were observed in PRWE total scores (p=0.268) or QuickDASH scores (p=0.058) among the three treatment groups.
• Grip strength recovery was similar across all groups (p=0.139).
• Operative treatments (volar plating and external fixation) resulted in significantly better radiographic alignment, including volar tilt (p<0.001) and radial height (p<0.001).

Conclusions:

• In elderly women with low-energy distal radius fractures, conservative management, volar plating, and external fixation yield comparable patient-reported outcomes.
• Despite superior radiographic alignment with surgical interventions, functional recovery did not significantly differ.
• Findings highlight the importance of individualized treatment selection, acknowledging potential differences in baseline fracture characteristics and the observational nature of the study.