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External fixation versus volar locking plate for displaced intra-articular distal radius fractures: a prospective
Rajeev Shukla1, Ravi Kant Jain, Neeraj K Sharma
1Department of Orthopedics, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, 453555, India, dr_rajeevshukla@rediffmail.com.
Background:
The objective of the study was to compare the efficacy of external fixation and volar plating on the functional parameter of displaced intra-articular (Cooney's type IV) distal end radius fractures using the Green and O'Brien scoring system.
Materials And Methods:
This prospective randomized study comprised 68 patients treated with external fixation and 42 patients treated with volar locking plates. The patients were followed up at 6 months and 1 year after surgery. The assessment of pain, range of motion, grip strength and activity were assessed at each follow-up visit and scored according to the Green and O'Brien scoring system.
Results:
At 1 year after surgery, we observed that external fixation showed significantly better results than volar locking plates using the Green and O'Brien scores for range of motion (22.0 ± 4.77 vs 19.89 ± 5.05), grip strength (19.91 ± 5.4 vs 16.89 ± 4.4) and final outcome (87.36 ± 11.62 vs 81.55 ± 11.32). No difference was found in pain and activity between these two groups of patients. Patients aged <50 years treated with external fixation showed excellent results (final score (91.57 ± 9.01) at 1 year follow-up.
Conclusion:
External fixation showed superiority over volar locked plating after 1 year of surgery.
Level Of Evidence:
IV.
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