Volar locking plate versus K-wire-supported external fixation in the treatment of AO/ASIF type C distal radius fractures: A comparison of functional and radiological outcomes.

Abstract

The aim of this study was to compare the functional and radiological outcomes of K-wire-supported bridging external fixation (KW-EF) and volar locking plate (VLP) in the treatment of comminuted intra-articular distal radius fractures. Patients treated for complex intra-articular distal radius fractures between February 2010 and April 2013 were retrospectively investigated. A total of 114 patients (42 females and 72 males) with a mean age of 44.9±15.4 (range: 18-86) years were evaluated. Wrist ranges of motion were measured using a universal goniometer, and hand grip strength was determined using hand dynamometers. The results were evaluated with Gartland-Werley score. QuickDASH questionnaire was administered in subjective functional assessment. Radiological evaluations were performed, with wrist radiographs obtained on the 3rd month and 2nd year. Wrist flexion, extension, pronation, and supination were all significantly better in the VLP group than in the KW-EF group at last control (p=0.001). Gartland-Werley, QuickDASH, and Visual Analog Scale were significantly better in the VLP than group than in the KW-EF group (p=0.003, p=0.003, and p=0.001, respectively). At the last follow-up, loss of grip strength compared with that on the uninjured side was 4% in the VLP group and 7% in the KW-EF group. VLP is a safe method with low complication rates. It is superior to KW-EF as it facilitates early return to daily activities and shows better functional and radiological outcomes in the 2nd year of treatment.