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

Abstract

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. 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. Patients in the DBP and VLP groups were similar in age at the time of surgery (DBP: 73.7 years; VLP: 71.4 years; <i>P</i> = .09), though those treated with DBP had a significantly higher body mass index (DBP: 31.4 vs VLP: 27.4; <i>P</i> < .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 (<i>P</i> > .05 for all). 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.