Abstract: Objective To investigate the clinical efficacy of palmar cut-and-replace locking splint internal fixation versus non-operative treatment of distal radius fractures in the elderly. Methods Eighty cases of elderly patients with distal radius fracture were collected from January 2022 to October 2023 in the Yili Friendship Kangmian Hospital, and were grouped according to different treatment plans (45 cases in the surgical group received palmar incision and reduction locking splint internal fixation, and 35 cases in the non-surgical group received manipulation and external fixation with a small splint), and were compared to the two groups' wrist function (assessed by the wrist function rating scale), fracture site and ulnar wrist pain score (assessed by the visual analogue rating scale), time to appearance of bone crust and disappearance of fracture line, and occurrence of complications 6 months after treatment. The two groups were compared in terms of wrist function (assessed by wrist function rating scale), pain scores at the fracture site and ulnar side of the wrist (assessed by visual analogue rating scale), time to the appearance of bone scab and disappearance of the fracture line, and occurrence of complications at 6 months after treatment. Results There was no statistically significant difference (P>0.05) in the comparison of the excellent rate of wrist joint function (93.33%, 42/45; 88.57%, 31/35) between the two groups at the 6th month after treatment. There was no significant difference between the fracture site and ulnar wrist pain scores of the two groups before treatment (P>0.05), and the above scores decreased significantly in both groups 6 months after treatment (P<0.05), and the fracture site and ulnar wrist pain scores of the surgical group were lower than those of the non-surgical group (P<0.05). The time between the appearance of bone scab and the disappearance of the fracture line was significantly shorter in the surgical group than in the non-surgical group (P <0.05). The total complication rate of the surgical group was 4.44% (2/45) lower than that of the non-surgical group, which was 17.14% (6/35), but no statistically significant difference was seen (P>0.05). Conclusion Metacarpal cut-and-replace locking splint internal fixation for distal radius fracture in the elderly has better efficacy, improves wrist function, and relieves the degree of pain between the fracture site and the ulnar side of the wrist.

Key words: distal radius fractures, elderly patients, Locking splints, non-operative treatment, clinical outcome