Geriatric Orthopaedic Surgery & Rehabilitation最新文献

{"title":"Re: Methodological Considerations in Frailty Assessment for Distal Radius Fracture Surgery.","authors":"Khansa Farooq, Fiza Nazir","doi":"10.1177/21514593261490242","DOIUrl":"10.1177/21514593261490242","url":null,"abstract":"","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261490242"},"PeriodicalIF":1.8,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoporosis Increases the Risk of Periprosthetic Fracture and Loosening after Total Elbow Arthroplasty: A Retrospective Cohort Study.","authors":"Akin A Adio, Mohammad Daher, Jehad Feras Alsamhori, James Satalich, Eric M Black, Brian W Hill, John G Horneff, Joseph A Abboud","doi":"10.1177/21514593261490230","DOIUrl":"10.1177/21514593261490230","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoporosis may adversely affect implant fixation and bone integrity following total elbow arthroplasty (TEA), yet its impact on postoperative complications remains incompletely defined. This study compared outcomes following TEA in patients with and without osteoporosis.</p><p><strong>Methods: </strong>A retrospective analysis was performed including 1,410 adult patients who underwent total elbow arthroplasty (TEA) with a minimum follow-up of two years. Patients with osteoporosis were matched to an equal number of patients without osteoporosis based on demographics, comorbidities, surgical indication, and preoperative inflammatory laboratory markers. Outcome measures included two-year rates of revision, periprosthetic fracture, implant loosening, prosthetic joint infection (PJI), ulnar nerve injury, and instability. A secondary analysis of 520 patients with osteoporosis compared those who received anti-osteoporosis medication to those who did not. Complication rates were compared between groups using chi-squared testing.</p><p><strong>Results: </strong>Patients with osteoporosis had higher two-year rates of periprosthetic fracture (4.4% vs. 1.4%, p<0.001) and implant loosening (5.0% vs. 2.3%, p=0.007). There were no differences in revision (p=0.144), PJI (p=0.479), ulnar nerve injury (p=0.228), or instability (p=0.692). Among patients with osteoporosis, medication use was not associated with differences in revision, implant loosening, PJI, or ulnar nerve injury. Patients on medication had a lower rate of periprosthetic fracture that did not reach significance (p=0.061).</p><p><strong>Conclusion: </strong>Osteoporosis is associated with increased risk of periprosthetic fracture and implant loosening following TEA. These findings suggest that impaired bone quality may contribute to structural modes of failure, highlighting the importance of preoperative bone health optimization in patients undergoing TEA.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261490230"},"PeriodicalIF":1.8,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Routine Early Post-operative X-Ray Following Partial Hip Replacement After Femoral Hip Fracture Is Unjustified: A Retrospective Study.","authors":"Meron Talmor, Geva Sarrabia, Shanny Gur, Boris Kuzmenko, Nadav Haddad, Elad Apt, Adi Lichtenstein, Ahmad Biadsi, Nissim Ohana, Tal Shachar, Yaron Brin","doi":"10.1177/21514593261484984","DOIUrl":"10.1177/21514593261484984","url":null,"abstract":"<p><strong>Background: </strong>Routine early postoperative radiographs following hemiarthroplasty for femoral neck fractures are widely performed despite limited evidence supporting their clinical utility in asymptomatic patients.</p><p><strong>Objectives: </strong>To determine whether routine early postoperative radiographs within the first three months after hemiarthroplasty influence clinical management or revision rates.</p><p><strong>Design: </strong>A single-center retrospective cohort study conducted at a tertiary academic institution, including consecutive patients who underwent cementless hemiarthroplasty for intracapsular femoral neck fractures between January 2015 and December 2024.</p><p><strong>Methods: </strong>Patients were included if they attended routine outpatient follow-up between six weeks and three months postoperatively with available AP and lateral radiographs, or if they underwent revision surgery during this period. Radiographs and medical records were reviewed to assess whether imaging findings altered clinical management, including weight-bearing recommendations or the need for revision surgery.</p><p><strong>Results: </strong>A total of 1,303 patients were included. The median follow-up time was 52 days (IQR 42-68 days). Routine postoperative radiographs did not result in any change in management or revision surgery rates in asymptomatic patients. The observed proportion of patients in whom routine radiographs altered management was 0% (95% confidence interval: 0.0%-0.28%). Seventy reoperations occurred during the follow-up period; all these patients presented with symptoms through the emergency department prior to intervention.</p><p><strong>Conclusion: </strong>Routine early postoperative radiographs after hemiarthroplasty for femoral neck fractures do not appear to influence clinical management in asymptomatic patients with satisfactory intraoperative imaging. A selective, symptom-driven imaging approach may safely reduce unnecessary radiation exposure and healthcare costs.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261484984"},"PeriodicalIF":1.8,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive Treatment of Die-Punch Fractures and Related X-Ray Parameters.","authors":"Jie Hu, Xu Zhang, Jingqiao Li, Xiaoting Shen, Jidong Li, Xiaoliang Yang","doi":"10.1177/21514593261487224","DOIUrl":"10.1177/21514593261487224","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the efficiency and safety of minimally invasive treatment for die-punch fractures using X-ray parameters.</p><p><strong>Methods: </strong>From May 2020 to May 2022, 32 patients (32 wrists; minimally invasive group) underwent percutaneous bony distraction, followed by external fixation. For comparison, we retrospectively reviewed another 35 patients (35 wrists; plating group) who underwent open reduction and internal fixation with plate and crew systems. Wrist movement was assessed. X-ray parameters and wrist pain were assessed. Wrist function was assessed using the Mayo Wrist Score. Patient satisfaction was assessed using the Short Assessment of Patient Satisfaction.</p><p><strong>Results: </strong>The mean age of the minimally invasive group was 38.6±12.3 years (range, 24-52 years). There were types B3 (n=11), C1 (n=10), C2 (n=8), and C3 (n=3). Bone healing achieved in all patients after 5.8±1.6 weeks. The mean age of the plating group was 37.1±13.2 years (range, 27-50 years). There were types B3 (n=13), C1 (n=9), C2 (n=9), and C3 (n=4). Bone healing achieved in all patients after 6.3±1.6 weeks. Two years after surgery, there were significant differences in radial height (12.1±2.6 mm <i>versus</i> 10±2.5 mm; <i>p</i><0.05) and ulnar variance (0.7±0.5 mm <i>versus</i> 1.4±0.9 mm; <i>p</i><0.05). There was a significant difference in wrist pain (0±1 <i>versus</i> 3±3; <i>p</i><0.01). There was no significant difference in wrist movement (<i>p</i>>0.05), grip strength (<i>p</i>>0.05), Mayo Wrist Score (<i>p</i>>0.05), or patient satisfaction (<i>p</i>>0.05).</p><p><strong>Conclusion: </strong>When treating die-punch fracture of distal radius, directly lifting the collapsed fragments through percutaneous bone distraction can effectively achieve reduction. The carpal bones can be used as a template to restore the alignment of the articular surface of the distal radius. External fixation can prevent re-collapse of the radius. The treatment can be an alternative technique, in addition to open reduction and plating.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261487224"},"PeriodicalIF":1.8,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reasons for Surgical Delay in HIP Fracture: What Can We Do From the Emergency Room?","authors":"Magali González-Colaço Harmand, Alicia Tejera Concepción, Noemi Elizabeth Alonso Morell, Manuel Enrique Fuentes Ferrer","doi":"10.1177/21514593261467156","DOIUrl":"10.1177/21514593261467156","url":null,"abstract":"<p><strong>Purpose: </strong>To identify the causes of surgical delay in patients with hip fracture, as recognized in the Emergency Department, and to assess their impact on mortality and hospital length of stay.</p><p><strong>Methods: </strong>A retrospective longitudinal study was conducted in a tertiary care Spanish hospital between January and June 2023, including 182 patients aged 65 years or older with hip fracture (76.9% women; mean age 836 ± 7.6 years). The reasons for surgical delay were analyzed, along with hospital length of stay and mortality during hospitalization and 10 months post-discharge.</p><p><strong>Results: </strong>Dementia was present in 41.2% of cases, and the mean Barthel Index was 75.4 points. The median time to surgery was 4 days (IQR: 3-6). Surgery was performed within 72 hours in 41.8% of patients. The most frequent causes of surgical delay were admission during weekends or holidays (90.6%), lack of operating room availability (19.8%), severe renal failure (31.1%), severe infection (24.6%), neurological instability (23.6%), antiplatelet therapy (21.7%), and absence of accompanying family members (16%). Overall mortality was 18.8%. In multivariate analysis, patients operated within 72 hours showed no significant difference in mortality. However, those operated after 72 hours had a significantly longer hospital stay.</p><p><strong>Conclusions: </strong>Surgical delay in hip fractures is influenced by clinical, social, and institutional factors. Familiarity with clinical practice guidelines may help reduce avoidable delays and improve overall hospital length of stay.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261467156"},"PeriodicalIF":1.8,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty and Time-To-Theatre for Elderly Hip Fracture Patients at a Regional Hospital in Australia: A Retrospective Cohort Study.","authors":"Stephanie Anderson, Sanne Norden, Ben Maslen, Luke Baitch","doi":"10.1177/21514593261487222","DOIUrl":"10.1177/21514593261487222","url":null,"abstract":"<p><strong>Objective: </strong>Elderly hip fracture patients constitute a vulnerable population in whom operative management is frequently required. Comorbidities commonly exist and are often a factor leading to delays in entry to the operating room. Our regional hospital manages many hip fractures and we sought to understand the demographic and medical details of this group, and whether frailty was a factor in time-to-theatre and length of stay (LOS).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of all patients over 65 years with hip fractures managed operatively at our regional hospital in Australia from 2018-2022. Demographics, and details of medical, surgical and anaesthetic management were collected. Data to allow calculation of a frailty score (the 11-item modified frailty index (mFI-11)) were collected to allow determination of a 'frail' and 'non-frail' cohort. These cohorts were compared with respect to time-to-theatre and LOS.</p><p><strong>Results: </strong>Our cohort consisted of 453 subjects. Median age was 83.1 years (range 65-103). Most subjects (71.5%) were living in the community pre-fracture. 324 subjects were 'frail'. Average time-to-theatre was longer in the frail cohort (28.9 h (frail) vs 22.0 h (non-frail), <i>P</i><0.0001), as was average LOS (7.4 days (frail) vs 6.3 days (non-frail), <i>P</i>=0.0077). However, after adjusting for ASA score, age and sex, there was no longer evidence of these relationships (time-to-theatre, P=0.054; LOS, <i>P</i>=0.477). Post hoc subgroup analyses revealed that frail subjects had longer LOS if time-to-theatre was >24h, and that frail subjects had higher odds of any complication than non-frail subjects, whether time-to-theatre was <24h or >24h.</p><p><strong>Conclusions: </strong>This study confirmed a demographic profile for elderly hip fracture patients at our hospital similar to that noted in large databases. Although the mFI-11 may retain value in defining clinically complex hip fracture patients, we were unable to find evidence of its utility as an independent predictor of time-to-theatre or LOS.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261487222"},"PeriodicalIF":1.8,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Depression, Anxiety, and Stress in Relation to Health-Related Quality of Life Among Patients Undergoing Total Knee Replacement in Jordan.","authors":"Wael Al-Tamimi, Majdi Alhadidi, Omar Alqaisi, Mohammed Dibas, Maha Subih, Ahmad Al-Rawashdeh, Patricia Tai","doi":"10.1177/21514593261485351","DOIUrl":"10.1177/21514593261485351","url":null,"abstract":"<p><strong>Background: </strong>Up to 25% of patients undergoing total knee replacement (TKR) for end-stage knee osteoarthritis report persistent pain, functional limitation, and reduced health-related quality of life (HRQoL). Although depression, anxiety, and stress are recognized determinants of surgical outcomes, their postoperative impact remains poorly studied in the Arab world, with no multicenter data from Jordan.</p><p><strong>Objectives: </strong>This study aimed to assess the postoperative depression, anxiety, and stress and their association with HRQoL among TKR patients in Jordan, and to identify independent predictors of HRQoL.</p><p><strong>Methods: </strong>A cross-sectional descriptive correlational design was used. A total of 140 adults were recruited from two government orthopedic hospitals in Jordan. Assessments were conducted at a single postoperative time point, 6-12 weeks following TKR surgery. Postoperative depression, anxiety, and stress were measured using the validated Arabic DASS-21 (α = 0.94), and HRQoL was assessed using the Arabic SF-12 (α = 0.84). Data were analyzed using descriptive statistics, Pearson correlation, and stepwise multiple linear regression.</p><p><strong>Results: </strong>Participants demonstrated moderate depression (M = 18.66, SD = 7.18) and anxiety (M = 14.13, SD = 7.63), and mild stress (M = 17.17, SD = 7.65) post-TKR. The mean HRQoL score was 39.56 (SD = 10.07). A statistically significant negative correlation was found between psychological distress and HRQoL (r = -0.27, p = 0.001). Multiple regression identified body mass index (BMI) (B = -0.382, p < 0.001) and postoperative psychological distress (DASS-21 total score; B = -0.054, p < 0.001) as independent predictors of HRQoL, explaining 17.7% of total variance. Educational level and comorbidities were significantly associated with postoperative depression, anxiety, and stress.</p><p><strong>Conclusion: </strong>Postoperative TKR patients in Jordan demonstrated poor overall HRQoL alongside moderate psychological distress. Routine psychological screening and targeted multidisciplinary interventions addressing modifiable factors such as BMI and psychological distress may help improve patient outcomes following TKR.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261485351"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Filtering Geriatric Patients by Age in TriNetX.","authors":"Joshua Wang","doi":"10.1177/21514593261485618","DOIUrl":"10.1177/21514593261485618","url":null,"abstract":"","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261485618"},"PeriodicalIF":1.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Outcomes of Older Adults in Long-Term Care Homes Following Hospitalization for Hip Fracture Surgery: A Retrospective Observational Cohort Study in Ontario, Canada.","authors":"Tiffany Yu, Maya Murmann, Nicholas Yee, Benoît Robert, David Kirkwood, Richard Perez, Seles Yung, Danielle Sinden, Amy T Hsu","doi":"10.1177/21514593261474558","DOIUrl":"10.1177/21514593261474558","url":null,"abstract":"<p><strong>Introduction: </strong>Hip fractures are debilitating for older adults, particularly those living in long-term care (LTC) homes. While surgical repair can alleviate pain and restore function, it carries the risk of several complications, including delirium, infection and cardiovascular events. Our objectives were to compare outcomes in LTC residents who did and did not undergo surgery following hospitalization for a hip fracture and assess the utility of existing frailty indices in differentiating outcomes in this population.</p><p><strong>Methods: </strong>We used a retrospective observational cohort of older adults from LTC homes in Ontario, Canada, hospitalized for hip fractures between January 1, 2015, and December 31, 2019. Primary exposure was surgery. Outcomes included in-hospital and 30-day post-discharge mortality, pain and functional mobility at 180 days post-discharge. Analyses were stratified by frailty level using four different indices. Logistic regression models were estimated to assess the associations between surgery, frailty, and outcomes.</p><p><strong>Results: </strong>Among 5,279 older adults meeting inclusion criteria (mean age = 87.0 years, 74.2% female), 86.1% received surgical repair. Following adjustment across multiple models, surgery was significantly associated with reduced in-hospital (adjusted odds ratio [aOR] = 0.27-0.29) and 30-day (aOR = 0.65-0.66) mortality. While the surgical group was less likely to experience pain (aOR = 0.88-0.91) and had higher odds of preserved or improved functional mobility (aOR = 1.35-1.37) at 180 days, these differences were not statistically significant. Likewise, while the frailty indices were predictive of mortality, they were not significantly associated with the odds of experiencing pain or functional mobility at 6 months. Among those who underwent surgery, RESPECT and CHESS were strongly associated with in-hospital and 30-day mortality, suggesting utility for perioperative risk stratification.</p><p><strong>Conclusions: </strong>In LTC residents with hip fractures who are eligible and fit for surgery, surgical management was associated with improved survival, which can be predicted using existing frailty indices.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261474558"},"PeriodicalIF":1.8,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operative Treatment Is Associated With Better Radiographic Alignment but Similar Patient-Reported Outcomes After Low-Energy Distal Radius Fractures in Women Aged ≥65 Years.","authors":"Mustafa Celtik, Cengizhan Kurt, Sercan Çapkın, Ali İhsan Kılıç, Eren Serkan Bahadır, Mehmet Akdemir","doi":"10.1177/21514593261474965","DOIUrl":"10.1177/21514593261474965","url":null,"abstract":"<p><strong>Introduction: </strong>Distal radius fractures are common in older women, but the optimal treatment remains debated. We compared conservative treatment, volar locking plate fixation, and external fixation in women aged ≥65 years with low-energy distal radius fractures, focusing on patient-reported outcomes (PROMs) and radiographic alignment.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included consecutive women aged ≥65 years treated at a tertiary center between January 2019 and January 2024. Only low-energy mechanisms, such as falls from standing height, were included. Patients were grouped according to treatment received: conservative management (n=44), open reduction and internal fixation with a volar locking plate (ORIF; n=47), or external fixation (n=43). The primary endpoint was the PRWE total score at ≥12 months. Secondary outcomes included QuickDASH, PRWE pain and function subscores, range of motion, grip strength, and radiographic parameters.</p><p><strong>Results: </strong>A total of 134 women were analyzed. The primary outcome, PRWE total score, did not differ significantly across groups: 15.40±6.71 after conservative treatment, 14.89±5.55 after volar plating, and 17.08±7.51 after external fixation (p=0.268). QuickDASH scores were 14.35±7.21, 17.86±6.57, and 15.44±7.61, respectively (p=0.058). Grip strength as a percentage of the contralateral side was also similar (88.62±5.85%, 90.09±5.54%, and 91.02±5.54%; p=0.139). Patients selected for operative treatment had better final radiographic alignment, including volar tilt (5.80±2.79°, 7.55±1.57°, and 7.07±1.65°; p<0.001) and radial height (9.73±2.42 mm, 11.77±1.91 mm, and 12.86±1.91 mm; p<0.001).</p><p><strong>Conclusions: </strong>In women aged ≥65 years with low-energy distal radius fractures, PRWE total score did not differ significantly across treatment pathways, despite better radiographic alignment in patients selected for operative treatment. Because treatment allocation was not randomized and baseline fracture morphology differed substantially between groups, these comparisons should be interpreted as descriptive observational findings after individualized treatment selection in routine practice. The absence of statistically significant differences in PROMs should not be interpreted as evidence of treatment equivalence or as a causal treatment effect.</p>","PeriodicalId":48568,"journal":{"name":"Geriatric Orthopaedic Surgery & Rehabilitation","volume":"17 ","pages":"21514593261474965"},"PeriodicalIF":1.8,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}