Distal radius fractures: External fixation for 6–7 Weeks versus early mobilization following 3–4 Weeks of external fixation and light splintage

Abstract

Background: External fixation for geriatric C-type distal radius fractures (DRF) often restricts early wrist motion. This study compares a strategy of early mobilization after 3–4 weeks of external fixation with lightweight support against the conventional approach of 6–7 weeks of continuous external fixation. Methods: A total of 174 patients aged 60 or older with C-type DRF were included. They were assigned to either an early mobilization group (n = 86), where external fixation was replaced with a lightweight support at 3–4 weeks, or a control group (n = 88) with conventional 6–7 weeks of external fixation. Outcomes included radiographic measures, functional scores (Gartland-Werley and Quick DASH), and satisfaction. Results: At week 7, no significant difference in radiographic data was observed between groups (all P > 0.05). At month 12, the control group showed better radiographic outcomes (P = 0.03). The early mobilization group had better functional scores at week 7 for both Gartland-Werley (P = 0.01) and Quick DASH (P = 0.02) compared to the control group. At 6 and 12 months, no significant differences were found between groups in either score (all P > 0.05). Patient satisfaction was significantly higher in the early mobilization group (P < 0.001). There were no significant differences in complication rates (P = 0.13). Conclusion: Transitioning to early mobilization after 3–4 weeks of external fixation facilitates earlier functional recovery and improves patient satisfaction compared to prolonged immobilization, despite a slight increase in ulnar variance that did not impact functional outcomes.