In this issue of JAMA Surgery, our colleagues from Australia and New Zealand have conducted a magnificent clinical trial by comparing volar locking plate fixation and closed reduction and casting for patients 60 years and older with distal radius fractures.1 The 12-month follow-up study was also published in JAMA Surgery,2 and the 24-month follow-up study provides additional insights regarding longer-term outcomes. This study, as with its predecessor, found no difference in outcomes between the 2 treatment groups. The authors concluded that surgical treatment with volar locking plates provided no important functional advantages over nonsurgical treatment at 12 and 24 months for patients who are 60 years and older.