Comparison between external fixator and DVR system for the treatment of AO type C distal radial fractures

Abstract

To compare the clinical effects of external fixator versus DVR system for the treatment of AO type C distal radius fractures. The clinical data of 52 patients with type C distal radial fractures treated with external fixator or DVR system respectively from January 2009 to December 2013 were analyzed retrospectively. In DVR system group, 31 patients were treated by open reduction and internal fixation with DVR system, involved 11 males and 20 females, with an average age of(47.3±10.9) years ranging from 24 to 65 years;according to AO/ASIF classification, 12 cases were type C1, 15 cases were type C2, 4 cases were type C3. In external fixator group, 21 patients were treated by closed reduction and cross wrist external fixation, involved 8 males and 13 females, with an average age of (48.1±12.1) years ranging from 26 to 69 years; according to AO/ASIF classification, 7 cases were type C1, 11 cases were type C2, 3 cases were type C3. The postoperative images, wrist joint functions and Gartland-Wetley scores were evaluated and compared. Thirty-one patients in DVR system group were followed up for 20.4 months(ranged from 13 to 36 months) and in external fixator group 21 patients were followed up for 17.1 months (ranged from 11 to 33 months) respectively. X-rays showed all fractures healed. The palm dip and radial inclination in the DVR system group were significantly better than in the external fixator group(P<0.05), while there was no significant difference in radial height and Gartland-Werley score(P>0.05). There was 1 case of wrist stiffness in the DVR system group; 2 cases of pin tract infection, 1 case of fixator loosening and 2 cases of wrist stiffness in the external fixator group. Clinical outcomes of DVR system fixation for type C distal radial fractures are better than that of external fixator fixation. However, DVR system fixation costs more and requires a secondary surgery to remove the internal fixation. The choices of surgical method depend on the clinical conditions of the patients.