Comparison of the clinical efficacy of external fixator combined with Kirschner wire and volar locking plate in the treatment of comminuted fractures of the distal radius

Abstract

Objective To investigate the clinical efficacy of external fixator combined with Kirschner wire and volar locking plate in the treatment of comminuted distal radius fractures. Methods From March 2012 to December 2015, 68 cases of comminuted distal radius fractures were treated with external fixator combined with Kirschner wire and volar locking plate. According to AO classification, there were 30 cases of C1 type, 24 cases of C2 type and 14 cases of C3 type. There were 34 cases in external fixator group and 34 cases in plate fixation group. The imaging results (palmar tilt, ulnar inclination and radial height) and wrist motion (dorsal extension, palmar flexion, radial deviation, ulnar deviation, pronation and supination) of the two groups were compared at 3 and 12 months after the operation. And the wrist function was evaluated by modified Gartland-Werley (GW) score. Results All the patients were follow-up from 6 to 24 months with an average of 12 months. There was 1 case of second metacarpal fracture in external fixator group and 1 case of median nerve entrapment in plate fixation group. No complications occurred in the rest of the patients. At 3 and 12 months after the operation, the palmar tilt, ulnar inclination and radial height from plate fixation group were greater than those from external fixator group, and the difference was statistically significant (P 0.05). The modified GW score of plate fixation group was smaller than that of external fixator group at 3 months after the operation, and the difference was statistically significant (t=-3.270, P 0.05). Conclusion Both of the fixation methods can obtain better clinical efficacy in treating type C distal radius fractures. The imaging results of plate fixation group are better than those of external fixator group. The short-term effect is obvious, but the long-term effect is similar. External fixator combined with Kirschner wire is a good choice for some patients with severe comminuted distal radius fractures that cannot be fixed by plate, and some patients with osteoporosis or diabetes. Key words: Radius fractures; Fracture fixation,internal; External fixator; Comparative study