Wrist Radiographic Indices and Patients’ Performance Following Three Surgical Methods for Management of Distal Radius Fractures: A Randomized Single-Blind Controlled Trial

Abstract

Background. Distal radius fracture has been reported as the most common type of extremity fractures in adults. No treatment method has been introduced definitely for this type of fracture, especially for maintaining hand function in the best state.
 The aim of this study — to assess the functional and radiological outcomes following three surgical methods, including external fixation, K-wire and external fixation with pinning.
 Methods. This parallel-designed randomized controlled trial was conducted on adult patients with intra-articular fracture of distal radius. The participants were allocated in three research groups with block random sampling, and were matched for their age and gender. Primary outcome was radiographic parameters, including radial inclination, radial height, ulnar variance and dorsal/palmar tilt. Secondary outcome was the patient’s performance examined with DASH and PRWE questionnaires. All participants were followed 6, 12 and 24 weeks after the surgery for evaluation of these outcomes.
 Results. Totally, 78 patients, including 42 male and 36 female with mean age of 46.94±11.05 years completed the research protocol. Although the four radiologic primary endpoints were in the normal clinical range after the intervention, a significant statistical difference was observed between the three groups (р0.001). Also, both DASH and PRWE score showed a significant decrease after the therapeutic interventions (р0.001).
 Conclusion. The statistically significant difference in the research outcomes of the external fixation with pinning can show that this treatment method theoretically preserves the anatomical condition better than the other two methods, and probably has better functional effects on short-term and intermediate-term results following the surgery.