Background: Older patients are treated for fracture with increasing frequency. Although studies on animals suggest that older mice and rats heal fractures more slowly, the clinical implications remain unclear. A better understanding of differences in healing with age can help customize fracture treatment. Our purpose was to retrospectively evaluate metacarpal fractures for healing time looking specifically at age-related differences. Methods: A retrospective review of patients treated for metacarpal fractures was conducted. Patients with incomplete charts or inadequate follow-up were excluded. One hundred ninety-eight charts were analyzed. Demographic and other patient factors were documented. Fracture characteristics and treatment type were documented. Fracture healing was determined clinically. Plain radiographs and examination were used in decision making. Results: Age was not associated with fracture healing time as a continuous variable ( P = .09). Patients above 75 years were not associated with increased healing time ( P = .58). Fracture characteristics were related to healing time: minimally displaced and comminuted fractures healed faster than oblique fractures, spiral fractures, or transverse fractures ( P = .048). Patients undergoing surgery healed faster than those without surgery ( P = .046). Renal failure negatively affected fracture healing time ( P = .03). Diabetes, hypothyroidism, and gender were not associated with healing time. Complications were not associated with age or other patient or fracture-related factors. Conclusions: Age does not affect clinical fracture healing time in adult. Therefore, older patients do not require disparate treatment. Other fracture-related factors and considerations such as functional demand and support systems might influence treatment decisions in fracture care.

Background: Distal radial fractures (DRF) are treated by internal fixation or closed reduction and casting (CRC). Over the years, various DRF classification systems and radiographic thresholds have been developed to guide management for orthopaedic surgeons, yet no gold standard has been established. This study sought to identify patients who presented with DRF and received treatment with CRC and determine if the process of selecting CRC-managed patients had improved by analyzing radiographic maintenance of reduction through final bone union. Methods: Retrospective review of a single-site database from 2012-2015 identified CRC-managed DRF with pre-CRC, post-CRC, and final-union radiographs. Outcomes compared included radial height (RH), radial inclination (RI), volar tilt (VT), teardrop angle (TDA), and ulnar variance (UV). Results: Post-CRC RH increased (7.5 to 10.4 mm, P<0.01) and regressed by 1.3 mm by union. RI increased (14.4 to 19.4 degrees, P<0.01) and returned to 17.3 degrees by union. Mean VT changed from −9.9 to 7.9 degrees (P<0.01) and to 1.1 degrees by union (P<0.05). TDA increased by union (34.1 to 44.5 degrees, P<0.01). UV changed from 1.2 to −0.2 mm (P<0.02) to 1.2 mm by union (P<0.01). At presentation the following parameters had differences when considering established favorable and unfavorable values at final-union: RH (9.58 vs. 5.26 mm), RI (16.9 vs. 8.1 degrees), and UV (0.4 vs. 3.9 mm) (all P<0.0005). Conclusions: Current literature demonstrated substantial variation in DRF management and expectations after CRC. This study revealed that RH greater than 9.5 mm and UV less than 3.8 mm at presentation were associated with successful reductions without functional deficit.