Which is better—casts or surgery—for older adults with arm fractures?

A recent study in the Journal of Orthopaedic Research found that cast immobilization is as effective as surgery for treating older patients with bone fractures near the wrist.

The study included 276 patients aged 70–89 years who suffered a distal radius fracture that didn’t penetrate the skin and that was treated conservatively or surgically between August 2018 and January 2022. Cast immobilization was used on 213 patients, whereas the other 63 had plates or pins placed during different types of surgery.

Nineteen patients experienced complications within the first year, with the most common being complex regional pain syndrome (5 patients who underwent surgery and 2 who received casts) and carpal tunnel syndrome (6 patients who received casts).

After 1 year, no statistically significant differences were found between the groups in terms of disability of the arm, shoulder, and hand, or regarding range of motion.

“There is a requirement for multi‐center prospective studies... using larger patient populations,” the authors wrote.

URL upon publication: https://onlinelibrary.wiley.com/doi/10.1002/jor.25665

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About the Journal
The Journal of Orthopaedic Research®, a publication of the Orthopaedic Research Society (ORS), is the forum for the rapid publication of high quality reports of new information on the full spectrum of orthopaedic research, including life sciences, engineering, translational, and clinical studies.

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