Casts an Optimal Option for Older Adults with Wrist Fractures

Casts an Optimal Option for Older Adults with Wrist Fractures

Fractures in older adults are a cause of concern as the healing process is often prolonged with brittle bones as a result of age and health conditions. In the event a fracture does occur, depending on the severity the doctor may suggest surgery or a cast. McKnights reports about a recent study that concludes a cast may be just as effective as surgery.


The study included 276 participants between the ages of 70 and 89 with a distal radius fracture. A distal radius fracture occurs when one of the two forearm bones breaks close to the wrist, and it does not break the skin. The participants were either given a cast or went through surgery between August 2018 and January 2022. About 77 percent or 213 individuals wore a cast and 63 of them had surgeries for plates or pins in their arms.


In the first year of surgery, 19 participants suffered from ongoing pain or complex regional pain syndrome. Of those individuals, five had a surgery procedure and two wore casts. Additionally, of the people who wore a cast, six were diagnosed with carpal tunnel syndrome later. Participants did not report any problems in their shoulder, hand, arm or range of motion.


The researchers wrote participants who wore casts did not have any performance issues when compared to those who had surgery. Metrics that were used included range-of-motion (ROM) tests and Disability of the Arm, Shoulder and Hand or DASH tests. 


With a year over year comparison, individuals who had external fixators with percutaneous pinning (EFPP) had higher DASH scores that those with isolated percutaneous pinning (IPP) and volar-locked plates (VLP).


The study concluded that one year after the surgery when DASH scores were compared, EFPP surgery scored higher than VLP and IPP.


Most people received casts, but according to the researchers that was irrespective of the severity of the fracture.


They stated, “Especially with distal radial fractures in the elderly, we believe that determining the most suitable kind of treatment that may be administered to the patient is the most significant problem, rather than focusing on the X-ray results.”


The study can be found in the Journal of Orthopaedic Research.


Cornerstone Rehab clinicians provide physical, occupational and speech therapy to older adults in skilled nursing facilities. Our clinicians are trained to provide rehabilitation therapy to patients who may be recovering from fractures.


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