Patient Expectations After Distal Radius ORIF: A Guide for Surgeons.

Abstract

Volar plate fixation is commonly used by orthopedic surgeons to treat distal radius fractures. This study aims to describe timelines and provide a practical guide for patient counseling following distal radius open reduction internal fixation. A retrospective observational study of patients undergoing fixation of distal radius fractures (Current Procedural Terminology [CPT] codes 25607-25609) by a single surgeon at a private orthopedic practice between December 2023 and June 2025. The study analyzed deidentified postoperative survey data, including pain, subjective function, return to work, driving, and hand therapy utilization. Thirty-four patients (mean age = 51.3 ± 17.1 years; 85.3% female) were included. Mean pain decreased from 4.34 ± 2.84 at 2 weeks to 1.08 ± 1.39 at 3 months, whereas subjective function improved from 18.4% ± 20.5% to 84.0% ± 14.2% of normal over the same period; the mean times to return to driving and work were 12.0 ± 11.4 days and 23.0 ± 25.3 days, respectively. Higher pain was consistently associated with lower functional recovery at all time points (<i>r</i> = -0.41 to -0.56, all <i>P</i> ≤ .016), and the CPT code 25608 was associated with lower odds of achieving this threshold (odds ratio, 0.06; <i>P</i> = .023). Patients undergoing volar plate fixation of distal radius fractures demonstrated pain reduction and improvement in function by 3 months, with variable return-to-work and driving timelines. These findings provide preliminary patient-centered recovery benchmarks that may help improve counseling and patient satisfaction but require validation in larger studies.<b>Level of Evidence:</b> Therapeutic III.