Surgical Treatment of Distal Radial Fractures with External Fixation Versus Volar Locking Plate: A Multicenter...

Area of Science:

• Orthopedic surgery
• Traumatology
• Evidence-based medicine

Background:

• Volar locking plate fixation (VLP) is increasingly used for unstable extra-articular distal radial fractures.
• External fixation (EF) is less common, with limited evidence guiding the shift in surgical approach.

Purpose of the Study:

• To compare the efficacy of VLP versus EF for treating displaced extra-articular distal radial fractures (OTA/AO type A3).
• To evaluate functional outcomes, pain, and radiographic measurements between the two fixation methods.

Main Methods:

• A multicenter randomized controlled trial included patients aged 18-70 with displaced extra-articular distal radial fractures.
• Patients were randomized to VLP or EF, with assessments at 6 weeks, 3 months, and 1 year.
• Primary outcome: Patient-Rated Wrist/Hand Evaluation (PRWHE) score. Secondary outcomes: QuickDASH, VAS pain, range of motion, grip strength, and complications.

Main Results:

• At 6 weeks, VLP showed significantly better PRWHE and QuickDASH scores than EF.
• At 1 year, while VLP demonstrated superior pain control and wrist motion, overall functional differences between groups were not significant.
• Major complication rates were similar between VLP and EF groups.

Conclusions:

• Volar locking plate fixation (VLP) facilitates earlier functional recovery in patients with distal radial fractures compared to external fixation (EF).
• Long-term functional outcomes at one year post-surgery were comparable between VLP and EF treatments.