Percutaneous Pinning Versus Volar Locking Plate Fixation in the Treatment of Intra_articular Distal Radius Fracture in Adults above 18 Years of Age

Abstract

Background and objectives: Distal radius fractures account for more than 20% of all fractures seen in the emergency department, unstable distal radial fractures can be managed by several treatment options including cast immobilization, percutaneous pinning, plate fixation and external fixation, the aim of the study is to compare percutaneous pinning and volar locking plate in the treatment of distal radius fracture AO C1 subtype. Methods: Thirty patients were included and divided into 2 equal groups, group 1 underwent volar locking plate fixation and group 2 underwent percutaneous k wire fixation, the functional and radiological outcomes were assessed by DASH and Stewart’s score respectively and range of motion was measured. Results: Plate group has significantly higher mean flexion at 3 and 12 months than those of the pin group, DASH score at 3 and 6 months was significantly higher in pin group (28.43 and 10.59 respectively) than plate group (20.47 and 16.75 respectively) but no significant difference was showed between the pin and plate groups at 12 months (14.58 vs 13.23 respectively). When the difference between preoperative and 12 months radiographs was measured ulnar variance, radial inclination, and palmar tilt were significantly higher in the plating group, however, the Stewart’s score distribution between both groups showed no significant differences. Conclusions: While there was no functional outcome difference at one year of follow up between patients treated with either treatments modality, patients requiring faster recovery and return to function can be offered open reduction and volar locking plate fixation.