A comparative study of mediumterm outcomes of type C distal radial fractures treated with volar locking compression plate and external fixation

Abstract

Objective To compare the mediumterm clinical effects of oblique T-shaped volar locking compression plate (LCP) and external fixation (EF) treating type C distal radial fractures. Methods Data of 60 patients with type C distal radial fractures who underwent surgery in our hospital from May 2010 to November 2012 were retrospectively analyzed. 36 patients received open reduction with LCP fixation (LCP group), among which there were 21 males and 15 females, and there were 20 left wrists and 16 right wrists with an average age of 45.94±16.29 years old (range, 17-80 years old). 24 patients received close reduction and external fixation (EF group), among which there were 16 males and 8 females, and there were 15 left wrists and 9 right wrists with an average age of 43.63±14.55 years old (range, 16-79 years old). The clinical results of wrist joint were assessed by range of wrist activity, VAS, Gartland-Werley wrist score, postoperative radial tilt angle, radial inclination angle and radial height. Results All the 60 patients were followed up successfully. The LCP group was followed up for 24 to 55 (42.03 ± 8.62) months. The EF group was followed up for 24 to 54 (37.24±9.77) months. In the LCP group, the average VAS score was 1.28±0.78, Gartland-Werley score 2.28±0.78, wrist flexion angle 50.89°±5.53° and wrist dorsiflexion angle 50.69°±5.38°. In the EF group, the average VAS score was 1.38±0.71, Gartland-Werley score 2.92±1.69, wrist flexion angle 50.96°±5.01° and wrist dorsiflexion angle 51.08°± 5.73°. No statistically differences were found in wrist joint function between two groups. In LCP group, radiological evaluation 2 years after operation showed that the average radial tilt angle was 10.69°±2.29, radial inclination angle 22.53°±1.95° and radial height 10.63±1.14 mm. In the EF group, radial tilt angle was 6.63°±2.76°, radial inclination angle 16.96°±4.41° and radial height 9.06±0.98 mm. Significant differences were found in radial tilt angle, radial inclination angle and radial height. No statistically differences were found in postoperative complication rates. Conclusion Locking compression plate (LCP) fixation and external fixation (EF) can obtain similar satisfactory mediumterm clinical outcome in treating type C distal radial fractures. Comparison with EF, LCP can achieve anatomic reduction under direct vision, and its radiological assessments including radial tilt angle, radial inclination angle and radial height were significantly better than external fixation. Key words: Radius fractures; Internal fixators; External fixators; Case-control studies