Commentary on an Article by K.A. Egol, MD, et al.: “Distal Radial Fractures in the Elderly: Operative Compared with Nonoperative Treatment”

Abstract

The authors hit the jackpot in terms of interest and applicability of a research topic. A distal radial fracture is one of the most common fractures, representing 16% of all fractures1. The treatment of distal radial fractures in patients over sixty-five years old is an important topic in light of the aging population, and these patients may have substantial comorbidities to consider when a treatment plan is formulated. In addition, the trends in the treatment of distal radial fractures have changed over the years. There were numerous articles in the 1990s on external fixation, after which the use of a dorsal buttress plate became popular. Combination treatment, such as percutaneous pin fixation along with use of an external fixator in more severe fractures, then became widely used. However, the evolution of the volar locked plate in the distal end of the radius was targeted for use in elderly patients with osteoporotic bone. The use of the locked plates has provided one example of how technology has changed treatment in orthopaedic surgery in recent years. The use of a volar locked plate compared with the other treatment methods may provide a desired radiographic outcome2. The question remains as to how a “perfect” radiographic result equates with functional outcome. This study compared operative and nonoperative treatment for distal …