Radiographic Outcomes of Dorsal Bridge Plating Versus Volar Locking Plate Fixation for Distal Radius Fractures in Elderly Patients: A Single-Center Retrospective Study.

BACKGROUND: Distal radius fractures (DRFs) are common, especially among the elderly, due to reduced bone density and a higher risk of falls. This study aims to compare radiographic outcomes and plate-related complications between volar locking plating (VLP) and dorsal wrist-spanning bridge plating (DBP) in the elderly population.

METHODS: We performed a retrospective chart review of patients aged 65 years and above who underwent surgical fixation for DRFs by VLP or DBP at a single institution. Pre- and postoperative radiographs were evaluated for metadiaphyseal involvement length, ulnar variance, radial height, radial inclination, and volar tilt. Concomitant injuries were recorded and compared between groups.

RESULTS: Patients in the DBP and VLP groups were similar in age at the time of surgery (DBP: 73.7 years; VLP: 71.4 years; P = .09), though those treated with DBP had a significantly higher body mass index (DBP: 31.4 vs VLP: 27.4; P < .05). Patients presenting with isolated wrist injuries were comparable between groups. Postoperative radiographic measurements-including ulnar variance, radial height, radial inclination, and volar tilt-showed no statistically significant differences between DBP and VLP (P > .05 for all).

CONCLUSIONS: In this single-center, multi-surgeon study, DBP for distal radius fractures in elderly patients produced radiographic outcomes comparable to VLP fixation. These results support DBP as a viable option in select older adults. Larger, multicenter studies with patient-reported outcomes on long-term follow-up are needed to define optimal patient selection and functional outcomes.