This matched cohort study (n=258) compares complication rates between operative and nonsurgical treatment of distal radius fractures in patients aged 65 and older, matching on fracture severity, sex, age, and injury energy. It asks whether surgery's radiographic benefits come at the cost of increased complications without functional gain.
When counseling an elderly patient (≥65) with a distal radius fracture, recognize that surgery—especially external fixation—carries a meaningfully higher complication rate without a demonstrated functional outcome advantage over nonsurgical management; if operating, volar locking plate fixation carries the lowest complication rate among operative options in this age group.
This matched cohort study (n=258) compares complication rates between operative and nonsurgical treatment of distal radius fractures in patients aged 65 and older, matching on fracture severity, sex, age, and injury energy. It asks whether surgery's radiographic benefits come at the cost of increased complications without functional gain.
When counseling an elderly patient (≥65) with a distal radius fracture, recognize that surgery—especially external fixation—carries a meaningfully higher complication rate without a demonstrated functional outcome advantage over nonsurgical management; if operating, volar locking plate fixation carries the lowest complication rate among operative options in this age group.