The impact of immediate surgical intervention versus conservative treatment on functional recovery and quality of life in older adults with distal radius fractures

Distal radius fractures are among the most prevalent fractures, accounting for approximately 17% of all fractures treated. Given the high prevalence of these fractures, particularly in the older adults population, determining the optimal treatment approach is of utmost clinical importance. While previous research has highlighted both the advantages and drawbacks of surgical and conservative treatment strategies, there remains a lack of consensus regarding which approach yields superior outcomes in terms of functional recovery and quality of life (QoL). This study was designed to determine whether immediate surgical intervention offered superior functional recovery and QoL outcomes compared with conservative treatment in older adults with distal radius fractures. A total of 63 older adults with distal radius fractures who were managed with either immediate surgical intervention (n = 32) or conservative treatment (n = 31). Functional recovery outcomes, QoL outcomes, complications, radiographic outcomes, and patient satisfaction and treatment adherence were assessed. Immediate surgical intervention yielded significantly better outcomes in several domains compared to conservative treatment. Analysis revealed superior range of motion (135.34° vs 107.89°, P < .001), grip strength (19.76 vs 15.87 kg, P = .004), Disabilities of Arm, Shoulder, Hand score (11.56 vs 14.45, P = .005), and Visual Analogue Scale score (2.76 vs 3.89, P = .003) in the immediate surgical intervention group. QoL outcomes also favored the surgical intervention group, with lower scores in somatization (72.03 vs 81.72, P < .001), emotion management (73.01 vs 81.41, P < .001), role play (75.25 vs 82.41, P < .001), and higher return to social function (71.23 vs 82.07, P < .001). Furthermore, radiographic outcomes indicated significantly better fracture alignment (96.88% vs 74.19%, P = .027) and shorter union time (8.34 vs 10.23 weeks, P = .001) in the immediate surgical intervention group. Patient satisfaction with treatment and treatment adherence were also higher in the immediate surgical intervention group. Immediate surgical intervention demonstrated superior functional recovery, QoL outcomes, radiographic outcomes, and patient satisfaction and treatment adherence compared to conservative treatment in older adults with distal radius fractures.