Abstract
Background/aimSurgical treatment of distal intraarticular radius fractures remains controversial. Our aim was to compare the clinical and radiological outcomes between volar plating (VP) and external fixation (EF) for distal intraarticular radius fractures two years postoperatively.Materials and methodsThis retrospective study included 59 patients with 62 intraarticular AO Type C distal radius fractures. We distinguished two groups: patients treated with internal fixation (volar locking plate, VP group: 41 fractures), and patients treated with an external fixator and K-wires (EF group: 21 fractures). The clinical assessment included range of motion, grip strength, disability of the arm, shoulder, and hand (DASH), and visual analog scale scores. Radiological measurements comprised flexion and extension, radial volar tilt, inclination, height, shortening, and ulnar variance.ResultsPostoperative grip strength and flexion angles were better after VP (P = 0.004, P = 0.009), but there was no difference in DASH scores (P = 0.341). Radial inclination was significantly different compared to that of the uninjured hand after VP (P = 0.0183), but not EF (P = 0.11). ConclusionVP and EF result in similar clinical and radiological outcomes after 2 years. Function is not restored to the functionality of the contralateral and noninjured hand.
Highlights
The distal radius is the most common fracture site in the upper extremity
We distinguished two groups: patients treated with internal fixation, and patients treated with an external fixator and K-wires (EF group: 21 fractures)
Postoperative grip strength and flexion angles were better after volar plating (VP) (P = 0.004, P = 0.009), but there was no difference in DASH scores (P = 0.341)
Summary
The distal radius is the most common fracture site in the upper extremity. Distal radius fractures represent 75% of forearm fractures [1,2] and 17% of all fractures [1,3,4]. Distal radius fractures may occur as a result of either a high-energy trauma in a younger population or a lowenergy trauma, such as a fall on the outstretched hand, in the elderly. In the latter group, increasing life expectancy, population aging, and the subsequently higher prevalence of osteoporosis have resulted in rising overall incidences of distal radius fractures, in reports to a degree of 17% to 100% over the past three to four decades [1,5,6]. While extraarticular fractures are mostly treated nonsurgically, displaced intraarticular distal radius fractures usually require surgical intervention. Various surgical procedures have been described, but stabilization with a volar locking plate or
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