Comparison of Functional Outcome of Distal End Radius Articular Fractures Treated with Below Elbow Cast and Volar Plating in Patients More Than 60 Years Old: A Prospective Comparative Study
DOI:
https://doi.org/10.56412/gmcp.2026.9.01.221Keywords:
Colle's Fracture, Osteoporosis, Distal Radius Fracture, Radius Fracture, Volar Locking PlateAbstract
Background: Distal radius fractures are among the most common osteoporotic fractures encountered in elderly individuals. Management of intra-articular distal radius fractures in patients older than 60 years remains controversial. Conservative management using below elbow cast immobilization has traditionally been preferred for elderly low-demand patients, whereas advances in fixation techniques have popularized volar locking plates for achieving anatomical reduction and early mobilization.
Methods: This prospective comparative study was conducted in the Department of Orthopaedics at Government Medical College, Patiala. Sixty patients aged more than 60 years with intra-articular distal radius fractures were included. Patients were divided into two groups: Group A (n=30), treated with below elbow cast immobilization following closed reduction, and Group B (n=30), treated with open reduction and internal fixation using volar locking plates. Functional outcome was assessed using Disabilities of Arm, Shoulder and Hand (DASH) score, Patient Rated Wrist Evaluation (PRWE) score, grip strength, wrist range of motion, and radiological parameters at regular follow-up.
Results: Patients treated with volar plating demonstrated significantly superior DASH and PRWE scores compared to the cast group. Better maintenance of radial height, radial inclination, and volar tilt was observed in the plating group. Grip strength and wrist range of motion improved significantly in the plating group. Malunion and secondary displacement were more common in the cast group.
Conclusions: Volar locking plate fixation provides superior functional recovery, improved radiological alignment, and earlier mobilization compared with below elbow cast treatment in elderly patients with intra-articular distal radius fractures.
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Copyright (c) 2026 Kumar H, Singh D, Kaur J, Sandhu K, Sahni G
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