Determinants of Functional Outcome in Distal Radius Fractures in High-Functioning Patients over the age of 55.

Abstract To determine the influence of treatment and radiographic parameters on patient reported functional outcomes on a population of non-frail elderly with distal radius fractures DESIGN:: Prospective cohort study SETTING:: Level 1 trauma center PATIENTS/PARTICIPANTS:: Patients over the age of 55 presenting with a distal radius fracture and a Canadian Study of Health and Aging (CSHA) Clinical Frailty Scale score of 1 or 2 INTERVENTION:: Closed reduction and casting or open reduction and internal fixation as per the treating surgeons decision. Radiographic scores at baseline, six weeks, twelve weeks, as well as DASH, SF-36 and PRWE scores up to 1 year after injury. Univariate analysis and linear regression analysis performed on outcome measures. No difference exists in outcomes based on treatment choice. Patients with ulnar positivity greater than 2mm at baseline, after treatment, and at final follow up had worse patient reported scores at one year. Persistent articular gaps and/or steps greater than 2 mm after treatment were also associated with worse patient reported outcomes. Even in high functioning patients over the age of 55, there was no difference in patient reported outcomes at one year in the open reduction group as compared to the closed reduction group. Instead, physicians should pay particular attention to radial shortening and persistent articular gaps following their chosen treatment plan for distal radial fractures. Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.