Assessment of Functional and Radiological Outcomes of Comminuted Intra-Articular Distal Radius Fracture Treated With Locking Compression Plate.

Abstract

BackgroundDistal radial fractures (DRFs) are a prevalent form of skeletal injuries that hinder a person from performing daily living activities. Although several treatment modalities have been established to manage DRF, an optimal intervention has not been identified for comminuted fractures. The use of locking compression plates (LCPs) is gaining popularity for fractures that cannot be anatomically reduced because they offer better stability and early recovery. Thus, this study aims to investigate the surgical outcome of comminuted intra-articular DRFs treated with LCPs.MethodologyWe performed open reduction and internal fixation in 30 patients (18 males and 12 females) with DRF and were followed up at regular intervals following the surgery (at three, six, twelve, and twenty-four weeks). The surgical outcome was assessed both from functional and radiological standpoints. The influence of LCP on functional outcome was evaluated based on the modified Mayo wrist score and the quality of reduction based on the Lindstrom criteria by observing volar tilt and radial inclination.ResultsFor radiological outcome, there was no variation in tilt/inclination of more than two degrees even after three months, which was a satisfactory result. Moreover, patients of all age groups showed early range of motion and functional benefit from LCP treatment. After six months of treatment, the patients experienced no pain and were able to return to their pre-injury jobs with little difficulty. Range of motion, work status, and grip strength after six months showed improvement of 15%, 7.8%, and 56%, respectively, compared to immediate postoperative assessments at three weeks. Although the end outcome with any treatment modality may yield similar results, when using LCPs, most patients experienced early functional improvement nearly six months after surgery.ConclusionsBy offering a lower risk of complications and early functional mobility, LCPs tend to restore the articular architecture of the fractured joint that results in the desired range of motion, grip strength, improved pain management, and functional status. Thus, LCPs appear to be a better alternative for distal end radial fractures than other treatment modalities.