Distal radius fractures are among the most common traumatic injuries in patients over 65 years old, but there is no consensus on their management. Our aim was to compare the functional outcome between surgical treatment with an anterior locking plate and orthopedic treatment.

There was no difference in functional outcomes between orthopedic and surgical treatment by osteosynthesis with volar locking plates in patients older than 65 years old.

A retrospective, non-randomized, multicenter study between 2017 and 2022 compared the functional outcome, after osteosynthesis with anterior locked plate versus orthopedic treatment of AO type C distal radius fractures in patients over 65 years old with a minimum follow-up of 6 mo. One hundred and fourteen patients were included, 68 received surgical treatment and 46 had orthopedic treatment. The mean follow-up was 40 mo (6–74 mo). The main endpoint was to evaluate the PRWE score at the last follow. Secondary endpoints included: assessment of wrist motion, radiological parameters of the distal radius (radial inclination, radial shortening, ulnar variance, and radial tilt) at last follow-up, and complication rate.

The mean PRWE score was 14.3 (± 10.9) for the surgical group and 15.8 (± 8.6) for the orthopedic group, with no significant difference (p = 0.27). There was no clinical difference in wrist motion. Radiological parameters at final follow-up were better in terms of anatomical reduction after surgery (p < 0.01). The complication rate was 17% (n = 12) after surgery and 7% (n = 4) after orthopedic treatment (p = 0.03).

This study found no significant difference in the PRWE score at final follow-up between osteosynthesis by volar locking plate and orthopedic treatment after an AO type C distal radius fracture in patients aged over 65. Orthopedic treatment thus remained a valid and satisfactory treatment option for this population.

III; Retrospective, comparative, non-randomized, multicenter study.