Clinical outcomes after open reduction and internal fixation with a volar locking plate for distal radius fracture in men

To describe the clinical outcomes during the 2 years after open reduction and internal fixation (ORIF) with a volar locking plate for distal radius fractures (DRFs) in men and to identify associated factors.

We retrospectively reviewed 109 men who underwent ORIF for DRFs between September 2016 and January 2021 with a minimum 2-year follow-up. Wrist range of motion, grip strength, pain visual analog scale, and disabilities of the arm, shoulder, and hand (DASH) scores were assessed at 3 months, 1 year, and 2 years postoperatively. Longitudinal changes in DASH scores were analyzed using a linear mixed-effects model adjusted for patient, fracture, and treatment-related factors.

Grip strength and DASH scores improved over time. Compared with 3 months, DASH scores decreased by 11.3 points at 1 year and 13.9 points at 2 years (both p < 0.001). Older age was independently associated with worse DASH scores (β = 0.318 per year, p < 0.001), most markedly at 3 months (age-by-time interaction, p = 0.016). Workers' compensation status was associated with poorer DASH scores (β = 8.732, 95% CI 0.496-16.968, p = 0.038), although the 95% CI included both negligible and clinically important differences. Neither fracture type nor trauma mechanism was significantly associated with postoperative DASH scores.

Clinical outcomes improved during the 2 years following ORIF for DRFs in men. Older age was associated with poorer DASH scores, particularly in the early postoperative period. The workers' compensation finding should be considered exploratory, given its uncertain clinical importance.