Distal radial fracture (DRF) is the second most common type of fracture experienced by older adults, leading to substantial consequences on independent living. Data were collected from the multicentre randomised Wrist and Radius Injury Surgical Trial (WRIST) (N=166). The association between radiographic measures of reduction, function, and patient-reported outcomes were reported.
Fracture management was achieved via volar locking plate, percutaneous pinning, external fixation, or casts.
Hand grip strength, wrist arc of motion, radial deviation, ulnar deviation, the Michigan Hand Outcomes Questionnaire (MHQ) for total score, function score, and activities of daily living (ADL) score were measured at 12 months follow-up.
Every degree increase in radial inclination away from normal (22°) grip strength in the injured hand was 1.1 kg weaker than the uninjured hand (95% CI 0.38-1.76; P=.004) and each millimetre increase toward normal (0 mm) in ulnar variance was associated with a 10.4-point improvement in MHQ-ADL score in patients ≥70 years (95% CI -16.84 to -3.86; P=.003). Neither of these radiographic parameters appeared to be associated with MHQ total or function scores.
Precise restoration of wrist anatomy is not associated with better patient outcomes for older adults with DRF. Patient preference and use of resources should be prioritised over exact realignment for care quality.