Functional and Radiological Outcomes in Operative Vs Non-Operative Management of Distal Radius Fractures in Adults
Abstract
Introduction: Distal radius fractures are among the most common upper limb fractures in adults, particularly in the elderly and those involved in high-energy trauma. The choice between operative and non-operative management remains a subject of debate, with considerations including fracture pattern, patient age, bone quality, and functional demands. Aims: This study aimed to compare the functional and radiological outcomes of operative versus non-operative management in adult patients with distal radius fractures. Methods: This prospective observational comparative study was conducted over one year at Calcutta National Medical College and Hospital, including 78 adult patients (≥18 years) admitted with isolated distal radius fractures. Patients were evaluated for side of injury, mechanism of fracture, functional recovery at different time points, wrist motion (flexion, extension, supination, pronation), radiological parameters (radial height, radial inclination, volar tilt), and complications. Data were collected systematically to compare outcomes between operative and non-operative management, focusing on functional and radiological results as well as adverse events. Results: In 78 patients (operative: 39, non-operative: 39; mean age 43.3 ± 12.7 years), baseline characteristics were similar. Early DASH scores favored operative treatment at 6 weeks (38.2 vs 45.6, p = 0.001) and 3 months (22.5 vs 27.1, p = 0.003), but were comparable at 6 months (12.4 vs 13.8, p = 0.12). At 6 months, flexion (75.2° vs 70.5°, p = 0.002) and extension (72.4° vs 68.3°, p = 0.004) were better in the operative group. Radiological outcomes were superior with operative management: radial height (11.8 vs 10.2 mm), radial inclination (22.5° vs 19.8°), and volar tilt (8.6° vs 5.9°) (all p < 0.001). Complications were low and similar overall (operative: 20.5%, non-operative: 23.1%, p = 0.78). Conclusion: Operative management of distal radius fractures in adults provides superior early functional recovery and better anatomical restoration compared to non-operative treatment. However, long-term functional outcomes at 6 months are comparable. Treatment choice should be individualized based on fracture type, patient age, activity level, and comorbidities.Keywords:
Distal radius fracture, operative management, non-operative management, functional outcome, radiological outcome, DASH scoreReferences
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