The authors performed a randomized trial to compare the functional and radiological outcomes of casting with percutaneous pinning in the treatment of extra-articular distal radial fractures in 60 elderly Chinese patients > 65 years. The radiological outcomes in terms of dorsal angulation, radial inclination, and radial length were significantly better in the K-wire group, whereas the Mayo wrist score, quality of life, healing rate, healing time, and complications were similar in both groups at 1 year.
Elderly patients with low functional demands often have good outcomes despite obvious deformity resulting from a fracture of the distal radius (Sebastian et al, JHS Am 2008). In healthy and active elderly patients, casting along may not maintain distal radial fracture alignment and surgery may be indicated to address the potential for wrist pain and functional impairment. The best method of fracture fixation in these cases remains debatable. Certainly, locking plate technology has become the most commonly employed treatment for these unstable fractures today.