Publication:

Distal radius fractures: a prospective study of the clinical and radiological outcomes in surgically managed patients

Background Objective of the research was to evaluate radiological and functional outcome in fractures of the distal radius treated by various surgical methods.

Methods 89 patients with distal radius fractures were randomly divided into three groups according to a computer-generated table of randomization. 40 patients were managed by K wire fixation. 22 patients were managed by external fixator. 27 patients were managed by volar plating technique. Anatomical restoration was evaluated by posterior-anterior and lateral radiographs obtained preoperatively and at 09 months of follow up to evaluate radial height (RH), radial inclination (RI) and volar tilt (VT). Functional outcome was evaluated using Mayo scoring system.

Results According to Mayo score, in K-wire group 72.5% (n=29) patients had excellent to good outcome, 17.5% (n=7) had fair outcome while as 10% (n=4) patients had poor outcome. In external fixator group 72.7% (n=16) patients had excellent to good outcome while as 27.3% (n=6) had fair outcome. In volar plating group 81.5% (n=22) patients had excellent to good outcome while as 18.5% (n=5) had fair outcome.

Conclusions In our study we found that volar locked plating provides advantage in dorsally or volarly displaced intra-articular fractures with excellent to good radiological outcome. However, in type B (partial intra-articular fractures) fractures, volar locking compression plate (LCP) and external fixator provide almost equivocal results. Percutaneous pinning can be recommended for extra-articular or simple intra-articular fracture patterns, with a loss of volar and/or RI but without significant radial shortening.