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Cast Immobilization Comparable to Surgery for Distal Radius Fractures in Elderly

No significant difference in DASH score, range of motion values seen at first postoperative year for CI, surgery

By Elana Gotkine HealthDay Reporter

THURSDAY, Aug. 24, 2023 (HealthDay News) — For older adults, cast immobilization (CI) performs similarly to surgical therapies for distal radius fractures (DRFs) at one year postoperatively, according to a study published online Aug. 23 in the Journal of Orthopaedic Research.

Mustafa Yalin, from Elazığ Fethi Sekin City Hospital in Turkey, and colleagues compared the clinical outcomes of CI versus surgical treatment after one year for DRFs in an elderly population, including patients aged 70 to 89 years. Data were included for 276 patients: CI was used on 213 (77.2 percent), while the other patients had volar-locked plates (VLP), received external fixators with percutaneous pinning (EFPP), and had isolated percutaneous pinning (IPP; 25, 25, and 13 patients, respectively).

The researchers found that 19 patients had complications; complex regional pain syndrome and carpal tunnel syndrome were most often documented. At the first postoperative year, EFPP resulted in significantly higher Disability of the Arm, Shoulder, and Hand (DASH) score values than VLP and IPP. For patients who received CI versus those who underwent surgery, no significant difference was seen in the DASH score and range of motion values at the first postoperative year.

“CI therapy still retains its validity and performs similarly to surgical therapies for DRFs in older individuals,” the authors write. “There is a requirement for multi‐center prospective studies that compare the four types of treatment models using larger patient populations.”

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