Comparison of locking compression plate versus external fixator in the treatment of AO type-C distal radial fractures

Abstract

Objective To compare the clinical effects of the volar locking compression plate (LCP) and external fixator in the treatment of the AO type-C distal radial fractures.Methods From October 2007 to October 2010,64 cases of AO type-C distal radial fractures which had been treated with volar LCP and external fixator were retrospectively analyzed respectively.LCP group consisted of 38 patients,including 13 males and 25 females with an average age of 45.1 years.According to AO/OTA classification,there were 15 type-C1,18 type-C2,and 5 type-C3.External fixator group consisted of 26 patients,including 12 males and 14 females with an average age of 47.1 years.There were 11 type-C1,13 type-C2,and 2 type-C3.Outcomes were assessed by radiographic parameters,function parameters,and Gartland-Werley functional score.Results All the patients were followed up.X-rays showed all fractures healed.LCP group was followed up for an average of 23.8 months.External fixator group was followed up for an average of 31.2 months.According to the Gartland-Werley score,the excellent and good rate was 81.6％ in the LCP group and 76.9％ in the external fixator group,with a Gartland-Werley score of 4.50±3.55 and 5.04±3.74 respectively.There were no significant differences in wrist flexion,extension,ulnar deviation,radial deviation,pronation,supination,the parameter of ulnar inclination and radial height and the Gartland-Werley score.The volar tilt was better in the LCP group than in the external fixator group.There were 2 cases of wound infection,1 case of median nerve injury,1 case of plate loosening in LCP group; 3 cases of pin tract infection,1 case of fixator loosening,and 2 cases of wrist stiffness in the external fixator group.Conclusion LCP group had better imaging outcomes with a reliable fixation,but both of the groups can achieve satisfactory clinical results.The choices of treatment method depend on the patient's clinical conditions. Key words: Radial fractures;  Fracture fixation, internal;  External fixators