A clinical study for the comparison of volar plate versus external fixation in distal radius fractures surgery

Abstract

Background: Distal radius fractures (DRFs) are the most common fractures in the upper extremity and cause major healthcare concerns. Objective: This study compares surgical outcomes of volar locking plates (VP) versus external fixation (EF) for AO-type distal radius C2 and C3 fractures. Methods: Patients (n=55) with AO-type C2 or C3 DRFs are recruited in this prospective, randomized study comparing volar plate fixation with external fixation. We have evaluated wrist range of motion, grip strength, and Michigan Hand Questionnaire at each patient visit and measured radiographic assessment (radial inclination, volar tilt, ulnar variance, and articular congruity) at 3-, 6- and 12-months post-surgery. Results: Both 3 and 6 months after trial, the VP group had significantly greater grip strength than the EF group but not at 12 months. At the 3 and 6-month follow-up did the VP group display a significantly greater range of motion than the EF group (P< 0.05). Only at 3 and 6 months did the VP and EF groups score significantly differently on the functional assessment. As measured by ulnar variance, the VP group showed superior radiologic results after 12 months. During the 12-month follow-up, there were 5 complications (22%) in the VP group and 7 (31%) in the EF group. No statistically significant differences were observed between complication rates by treatment or complication types. Conclusion: The functional outcomes for comminuted intra-articular distal radius fractures as observed following distal radius surgery offer insight into treatment decisions and interpretations of treatment outcomes.