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

BACKGROUND:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSION:

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.

• Authors: Altuğ Duramaz, Mustafa Gökhan Bilgili, Evren Karaali, Berhan Bayram, Nezih Ziroğlu, Cemal Kural
• Journal: Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES (Ulus Travma Acil Cerrahi Derg) Vol. 24 Issue 3 Pg. 255-262 (May 2018) ISSN: 1306-696X [Print] Turkey
• PMID: 29786822 (Publication Type: Comparative Study, Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Bone Wires
• External Fixators
• Female
• Fracture Fixation (instrumentation)
• Humans
• Male
• Middle Aged
• Radiography
• Radius Fractures (diagnostic imaging, surgery)
• Retrospective Studies
• Treatment Outcome
• Young Adult