Effect of Postoperative Immobilization Following Volar Plate Fixation of Distal Radius Fractures on Functional Outcomes and Wrist Stiffness: A Retrospective Cohort Study

Abstract

Background: Distal radius fractures are the most common upper limb fractures specifically in the elderly population. Open Reduction Internal Fixation with Volar plating remains the preferred method for Surgical Fixation in unstable fractures. There is a common practice to keep the fracture immobilized to ensure comfort and stability. This study evaluates postoperative patient-reported outcomes and stiffness in patients undergoing ORIF who experienced prolonged casting (>14 days) in the peri operative period.
Methods: This retrospective cohort study was conducted at DGH in UK. A total of 150 patients who underwent volar plate fixation for distal radius fractures between July 2024 and December 2025 were included. Patient demographics, fracture characteristics, and operative details were extracted from electronic medical records. Functional outcomes were assessed using the Patient-Rated Wrist Evaluation (PRWE) score at ≥6 months, and wrist stiffness was assessed from clinic documentation at 3 months.
Results: PRWE data were available for 115 patients. Patients managed without postoperative backslab immobilisation demonstrated significantly lower PRWE scores compared with those treated with backslab immobilisation (13.47 ± 17.20 vs 21.50 ± 23.21, p = 0.036). Stiffness rates at 3 months were similar between groups (31.3% vs 34.3%, p = 0.692).
Conclusions: Our Study findings support timely surgical fixation in line with BOAST guidance and advocate early postoperative mobilization without routine casting to improve outcomes & reduce healthcare burden.