Displaced Distal Radius Fractures Presented Late: A Randomized, Prospective Comparative Study of Two Methods of Treatment

Abstract

BACKGROUND AND AIM OF THE WORK: Fractures of the distal radius are common, yet there is no clear consensus on their management. A fracture that slips after reduction should be considered to be unstable and probably requires fixation. Latepresenting cases come with more complexity. This study aims to evaluate the early results of a minimally invasive surgery by the modified Kapandji technique versus invasive surgery through open reduction and internal fixation by plate and screws in treating these challenging fractures. RESEARCH DESIGN AND METHODS: Prospective study restricted for those adult patients with displaced distal radius fractures presented within 3 to 6 weeks from date of injury. The study patients were randomly divided into two groups each one included 23 patients. Group I, managed with Kapandji method, as modified by Fritz et al. and group II was treated by the conventional open reduction and internal fixation by plate and screws. RESULTS: The result at final follow-up was excellent in 63.2%, good in 26.3%; fair in 10.5% and no poor results in group I compared to 66.6% excellent, 23.9% good, 9.5% fair and no poor results in group II. CONCLUSIONS: Excellent to good results can be achieved in most of cases. As no significant difference in outcome between the two ways, the modified Kapandji technique is preferred as it is less invasive, easy to perform, less costly and time saving.