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To compare the impact of chronologic versus physiologic age on recovery outcomes in distal radius fractures treated with casting or surgery.

February 13, 2023JAMA Network OpenOpen Access

Comparison of Distal Radius Fracture Outcomes in Older Adults Stratified by Chronologic vs Physiologic Age Managed With Casting vs Surgery

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To compare the impact of chronologic versus physiologic age on recovery outcomes in distal radius fractures treated with casting or surgery.
Retrospective analysis of participants from the Wrist and Radius Injury Surgical Trial (WRIST) enrolled between April 2012 and December 2016.
Participants older than 60 years with unstable distal radius fractures, receiving either casting or surgery.
Primary outcome measured was the Michigan Hand Outcomes Questionnaire (MHQ) score at multiple time points.
293 participants (mean age 71.1 years) evaluated; increased chronologic age correlated with higher MHQ scores in the surgery group at all time points.
Casting group showed decreased MHQ scores at 12 months; P = 0.03 indicating significant change.
High activity levels linked to improved MHQ scores in the surgical cohort at both 6 weeks and 12 months (P = 0.02).

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Randomized trial compares recovery outcomes of casting versus surgery in older adults with fractures, suggesting implications for treatment strategy.

Jayaram et al. (2023) studied this question.

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Randomized trial compares recovery outcomes of casting versus surgery in older adults with fractures, suggesting implications for treatment strategy.