Radiographic Outcomes of Distal Radial Fractures in Patients Older Than 90 Years: Preoperative and Postoperative Correlations

BACKGROUND: This study evaluates longitudinal changes in key radiographic parameters and examines their correlation with clinical outcomes following surgical treatment of distal radius fractures (DRFs) in patients aged 90 years and older, while also assessing the safety and complications associated with this treatment in nonagenarians. METHODS: A retrospective review was performed of patients aged 90 years and older who underwent surgical treatment for DRFs. Demographic data were collected. Radiographic alignment was assessed preoperatively, immediately postoperatively, and at final follow-up using dorsal tilt, ulnar variance, radial inclination, and radial height. Functional outcomes were evaluated at final follow-up using the Disabilities of the Arm, Shoulder, and Hand (DASH) score and visual analog scale. Surgical complications and reoperations were also recorded. RESULTS: Seventy-three patients aged 90 years and older (mean age, 92 ± 2 years; 89% women) were included. All radiographic parameters improved and were maintained at final follow-up with a mean of 4.1 months. The final mean DASH score was 29. No significant correlations were observed between preoperative radiographic alignment and final function; however, a weak correlation was found between immediate postoperative height and final DASH score. Overall, minor and major complications occurred in 15% (n = 11) of patients. CONCLUSIONS: Surgical treatment of DRFs results in sustained radiographic alignment and meaningful improvements in pain and function, with an acceptable complication profile in nonagenarian patients. Although correlations between radiographic alignment and functional outcomes were modest, operative management appears to be a safe and effective option in carefully selected patients aged 90 years and older.