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Two Wrist Fracture Treatments Have Similar Outcomes

Elderly distal radial fracture patients treated with, without surgery have similar functioning at one year

THURSDAY, Aug. 12 (HealthDay News) -- Elderly patients with distal radial fractures treated with either surgery or cast immobilization achieve similar functional status one year later, although the surgical patients have greater grip strength, according to a study in the Aug. 4 issue of the Journal of Bone & Joint Surgery.

Kenneth A. Egol, M.D., of the New York University Hospital for Joint Diseases in New York City, and colleagues examined 90 patients, older than 65, who were treated for a displaced distal radial fracture either by surgery (plate-and-screw fixation or external fixation) or non-surgically (cast immobilization). The researchers took radiographs and recorded functional scores prior to treatment. Clinical and radiographic follow-ups were conducted at two, six, 12, 24, and 52 weeks.

The researchers found that the patients who had surgery had better wrist extension at 24 weeks than those who did not have surgery, but the difference had disappeared by one year. No differences in functional status were observed at any of the follow-up points. However, radiographic outcomes at each follow-up interval, and grip strength at one year, were better among the surgery subjects. There were no differences in complications for the two groups.

"Our findings suggest that minor limitations in the range of wrist motion and diminished grip strength, as seen with nonoperative care, do not seem to limit functional recovery at one year," the authors write.

At least one author disclosed financial ties to Stryker, Synthes, and/or Biomet.

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