A comparative study of the efficacy of minimally invasive surgery and conservative treatment for distal radius fractures due to osteoporosis in the elderly.
Junhao Zeng, Zimeng Chen
Abstract
Open AccessThis retrospective study compares the therapeutic effects of minimally invasive surgery (MIS) and conservative treatment (CT) for osteoporotic distal radius fractures (DRFs) in elderly patients. A total of 200 elderly patients (≥65 years) with osteoporotic DRFs who were treated in our hospital between January 2021 and December 2024 were included. Based on the treatment method recorded in the medical charts, patients were assigned to the MIS group (n = 100) or the CT group (n = 100). In the MIS group, surgical procedures included percutaneous Kirschner wire fixation, volar locking plate implantation, or external fixation, as documented in operative records. In the CT group, patients underwent manual reduction followed by plaster immobilization. Clinical outcomes extracted from follow-up records included wrist function scores (Gartland-Werley, DASH, PRWE), fracture healing time, radiological parameters (radial height, palmar tilt, ulnar variance), complication rates, SF-36 quality of life (QoL) scores, and patient satisfaction. The MIS group had superior wrist function scores at 3, 6, and 12 months (P < .05). Healing time was shorter in the MIS group (8.2 ± 1.5 vs 12.4 ± 2.3 weeks; P < .001). Radiological outcomes were better in the MIS group at 6 months (P < .05). Complications were lower in the MIS group (10% vs 25%; P = .012). QoL (SF-36) and satisfaction (88.6 ± 6.2 vs 75.4 ± 7.1; P < .001) were higher in the MIS group. MIS offers significant advantages over CT for osteoporotic DRFs in the elderly, improving wrist function, accelerating healing, reducing complications, and enhancing QoL and satisfaction. Despite higher costs, MIS is more cost-effective due to better outcomes. Further research should optimize techniques and validate long-term efficacy through multicenter studies.