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Distal radius fractures are one of the most common fractures seen in the elderly. With the younger physiological age of patients over 60 years, the expectation of functional outcomes is changing. The management of distal radius fractures in the elderly patient, especially those over the age of 80, has not been well defined. The purpose of this study was to compare operative to nonoperative treatment of distal radius fractures in patients older than 80 years to determine if there is any difference in functional outcomes or complications.


A retrospective review was performed to identify patients 80 years or older who were treated for a distal radius fracture with either open reduction internal fixation (ORIF) or nonsurgical management. Medical records were reviewed for demographics, past medical history, and functional outcomes including wrist range of motion, quick Disabilities of the Arm, Shoulder, and Elbow (DASH), VAS pain scores, and complications.


There were 237 patients in the operative cohort and 458 patients in the nonoperative cohort. Average age was 84 years in the operative and 86 years in the nonoperative groups. Wrist flexion was significantly better in the operative cohort; 50 versus 45 degrees in the nonoperative group. The remainder of wrist range of motion was not different between the two groups. The quick DASH at final follow-up in the operative cohort was significantly better than the nonoperative group; 26 versus 45. Complications were similar in both groups.


Distal radius fractures in patients older than 80 years of age treated with ORIF have superior functional outcomes and comparable complication rates than those treated nonoperatively. Increased functionality of the elderly and updated implant design make surgical management of these fractures an effective treatment that leads to improved outcomes in patients over 80 years of age.