DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20213076

Comparison of clinic-radiological and functional outcome of intra articular distal end radius fractures managed by volar locking plate versus external fixation

Pankaj Vir Singh, Gagandeep Singh, Tejpal Singh, Abdul Ghani, Zubair A. Lone

Abstract


Background: Distal end radius (DER) fractures are most common fractures in upper limb. Intra articular fractures can be managed either by open reduction and internal fixation by volar locking plate or can be managed by closed reduction and external fixator application or by percutaneous pinning. The purpose of our study was to compare the functional outcome of volar locking plate with that of external fixation.

Methods: A prospective cohort study was conducted between June 2019 to June 2020 in Government Medical College, Jammu on 46 patients with intra articular distal end radius fractures. Of which 26 were managed by volar locking plate and 20 were managed by external fixator. the results of both groups were compared on the basis of radiological parameter and range of motion achieved post operatively. The functional outcome was evaluated using DASH score and Gartland–Werley scale.

Results: Final range of motion, grip strength were better in patients managed with volar locking plate (VLP) as compared to those who were managed with external fixator (EF). Radiographically, volar tilt, radial height were all better in VLP group than EF.

Conclusions: We concluded that VLP is superior method to maintain reduction till the union occurs and prevents the fracture collapse in intra articular distal end radius fractures as compared with external fixator. Thus, giving better functional and radiological outcome than the external fixator.


Keywords


Intra articular DER fractures, ORIF with VLP, CR and external fixation, DASH score, Gartland–Werley scale

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References


The evolution of distal radius fracture management: Rafael j Diaz Garcia& Kevin c Chung. Grays anatomy for student. 688-712.

Vasenius J. Operative treatment of distal radius fractures. Scand J Surg. 2008;97(4):290-7.

Capo JT, Swan KG, Tan V. External fixation techniques for distal radius fractures. Clin Orthop Relat Res. 2008;445:30-41.

Gofton W, Liew A Distal radius fractures: nonoperative and percutaneous pinning treatment options. Orthop Clin North Am. 2006;38(2):175-85.

Payandeh JB, McKee MD. External fixation of distal radius fractures. Orthop Clin North Am. 2007;38(2):187-92.

Leung F, Tu Y, Chew WY, Chow SP. Comparison of external and percutaneous pin fixation with plate fixation for intra-articular distal radius fractures: a randomized study. J Bone Joint Am. 2008;90:16-22485.

Bentohami A, de Burlet K, de Korte N, van den Bekerom MPL, Goslings JC, Schep NWL Complications following volar locking plate fixation for distal radial fractures: a systematic review. J Hand Surg Eur Vol. 2014;39(7):745-54.

Disseldorp DJG, Hannemann PFW, Poeze M, P R G. Brink Dorsal or volar plate fixation of the distal radius: does the complication rate help us to choose? J Wrist Surg. 2016;5(3):202–10.

H J Kreder, D P Hanel, J Agel, M McKee, E H Schemitsch, T E Trumble, D Stephen Indirect reduction and percutaneous fixation versus open reduction and internal fixation for displaced intra-articular fractures of the distal radius: a randomised, controlled trial. J Bone Joint Surg Br. 2005;87(6):829-36.

Richard MJ, Wartinbee DA, Riboh J, Miller M, Fraser Leversedge J, David S. Analysis of the complications of palmar plating versus external fixation for fractures of the distal radius. J Hand Surg Am. 2011;36(10):1614-20.

Reynolds PR, Beredjiklian PK. External fixation of distal radius fractures: do benefits outweigh complications? Curr Opin Orthop. 2001;12(4):286-9.

Hudak PL, Amadio PC. Bombardier Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder, and head). Am J Ind Med. 1996;29(6):602-8.

von Recum J, Matschke S, Jupiter JB, Ring D, Souer JS, Huber M, Audige L. Characteristics of two different locking compression plates in the volar fixation of complex articular distal radius fractures. Bone Joint Res. 2012;1(6):111-7.

Shin EK, Jupiter JB. Radioscapholunate arthrodesis for advanced degenerative radiocarpal osteoarthritis. Tech Hand Up Extrem Surg. 2007;11(3):180.

Zamzuri Z, Yusof M, Hyzan MY. External fixation versus internal fixation for closed unstable intra-articular fracture of the distal radius. Early results from a prospective study. Med J Malaysia. 2004;59(1):15-9.

Abramo A, Kopylov P, Geijer M, Tägil M. Open reduction and internal fixation compared to closed reduction and external fixation in distal radial fractures: A randomized study of 50 patients. Acta Orthop. 2009;80(4):478-85.

Schmelzer-Schmied N, Wieloch P, Martini AK, Daecke W. Comparison of external fixation, locking and non-locking palmar plating for unstable distal radius fractures in the elderly: Int Orthop. 2009;33(3):773-8.

Jupiter JB. Current concepts review-Fractures of the distal end of the radius. J Bone Joint Surg (Am). 1991;73-A:461-9.