title: Determinants of Functional Outcome in Distal Radius Fractures in High-Functioning Patients Older Than 55 Years.
abstract: OBJECTIVE
  To determine the influence of treatment and radiographic parameters on patient-reported functional outcomes on a population of non-frail elderly with distal radius fractures.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Level 1 trauma center.
  
  
  METHODS
  Patients older than 55 years presenting with a distal radius fracture and a Canadian Study of Health and Aging Clinical Frailty Scale score of 1 or 2.
  
  
  METHODS
  Closed reduction and casting or open reduction and internal fixation as per the treating surgeons' decision.
  
  
  METHODS
  Radiographic scores at baseline, 6 weeks, and 12 weeks, as well as Disabilities of the Arm, Shoulder and Hand, Short Form 36, and Patient-Reported Wrist Evaluation scores up to 1 year after injury. Univariate analysis and linear regression analysis were performed on outcome measures.
  
  
  RESULTS
  No difference exists in outcomes based on treatment choice. Patients with ulnar positivity greater than 2 mm at baseline, after treatment, and at final follow-up had worse patient-reported scores at 1 year. Persistent articular gaps and/or steps greater than 2 mm after treatment were also associated with worse patient-reported outcomes.
  
  
  CONCLUSIONS
  Even in high-functioning patients older than 55 years, there was no difference in patient-reported outcomes at 1 year in the open reduction group as compared with the closed reduction group. Instead, physicians should pay particular attention to radial shortening and persistent articular gaps following their chosen treatment plan for distal radial fractures.
  
  
  METHODS
  Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Sunnybrook Health Sciences Centre, Toronto, ON, Canada; †University of British Columbia; and ‡University at Maryland School of Medicine.
authors.forename: Jeremie
authors.initials: J
authors.lastname: Larouche
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Pike
authors.forename: Gerard P
authors.initials: GP
authors.lastname: Slobogean
authors.forename: Pierre
authors.initials: P
authors.lastname: Guy
authors.forename: Henry
authors.initials: H
authors.lastname: Broekhuyse
authors.forename: Peter
authors.initials: P
authors.lastname: OʼBrien
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Lefaivre
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001175:Arthrography / Q000706:statistics & numerical data*; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D059026:Diagnostic Self Evaluation; D005260:Female; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D011885:Radius Fractures / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D016896:Treatment Outcome