Optimizing Treatment Strategies for Distal Radius Fractures in Osteoporosis: A Comparative Review

Abstract

Osteoporosis is a common yet underdiagnosed condition that increases the risk of fractures, contributing to substantial morbidity, mortality, and healthcare costs. Distal radius fractures (DRFs) are some of the most common fractures associated with osteoporosis and often precede more severe fractures. Managing DRFs in patients with osteoporosis can be a challenge due to altered bone quality, which can affect healing and surgical fixation. This review examines both operative and nonoperative management strategies for DRFs in osteoporotic patients, emphasizing the importance of individualized treatment. Surgical interventions, like open reduction and internal fixation (ORIF) with plating, can facilitate early mobilization and improved alignment, especially in more active patients. However, osteoporosis poses risks such as hardware failure, infection, and malunion, calling for careful patient selection. Conversely, nonoperative management may be more suitable for patients with lower functional demands or higher surgical risks, despite the increased risk of malunion. By adapting treatment strategies to individual patient characteristics, orthopedic surgeons can optimize outcomes, minimize complications, and potentially prevent future fractures. Both operative and nonoperative treatments can yield positive outcomes when personalized to the patient’s needs.