[Complex distal radius fractures in young patients. Comparison between external fixator and volar plate]

Distal radius fractures in young, working-age patients are frequent and are associated with potential disability in case of inappropriate treatment. Our hypothesis is that there is no difference between patients treated with a volar plate and those treated with closed reduction and external fixation.

We studied 69 patients with complex distal radius fractures. They were prospectively and randomly assigned to treatment with a volar plate or an external fixator: they were followed-up and assessed at one year using two scales, the Visual Analog Scale (VAS) and the McDermid et al. Functionality Scale.

Both groups showed good results at one year. Measurements in the pain Visual Analog Scale and disability measured with the McDermid et al. scale were not statistically significant. Higher scores mean greater disability. Scores above 20 were considered as failures. We found 2 cases with complications in the F group; one with material dislodgement and one with malunion, without significant differences.

Both treatments show good results in the medium-term; no differences were found between both groups regarding pain and residual disability. Complications were few and they were addressed conservatively; they were less frequent with open reduction and internal fixation. When ranges of motion and the complication rate were compared, the volar plate showed a statistically significant difference in a decreased complication risk.