Is locking plate fixation a better option than casting for distal radius fracture in elderly people?

Abstract

Objectives: To compare the outcomes of locking plate fixation versus casting for displaced distal radius fracture with unstable fracture pattern in active Chinese elderly people.

Design: Historical cohort study.

Setting: Orthopaedic ward and clinic at Tseung Kwan O Hospital, Hong Kong.

Patients: Between 1 May 2010 and 31 October 2013, 57 Chinese elderly people aged 61 to 80 years were treated either operatively with locking plate fixation (n=26) or conservatively with cast immobilisation (n=31) for unstable displaced distal radius fracture.

Main outcome measures: Clinical, radiological, and functional outcomes were assessed at 9 to 12 months after treatment.

Results: The functional outcome (based on the quick Disabilities of the Arm, Shoulder and Hand score) was significantly better in the locking plate fixation group than in the cast immobilisation group, while clinical and radiological outcomes were comparable with those in other similar studies.

Conclusions: Locking plate fixation resulted in better functional outcome for displaced distal radius fracture with unstable fracture pattern in active Chinese elderly people aged 61 to 80 years. Further prospective study with long-term follow-up is recommended.

Keywords: Aged; Casts, surgical; Fracture fixation, internal; Radius fractures.