A randomized comparison of volar plate and external fixation for intra-articular distal radius fractures

Young Hak Roh, Beom Koo Lee, Jong Ryoon Baek, Jung Ho Noh, Hyun Sik Gong, Goo Hyun Baek

Research output: Contribution to journalArticlepeer-review

48 Scopus citations

Abstract

Purpose To compare surgical outcomes of volar locking plates (VP) and external fixation (EF) (with or without intra-focal fixation) for AO-type C2 and C3 fractures of the distal radius.

Methods From an initial group of 92 patients with AO-type C2 and C3 distal radius fractures who were enrolled in a prospective, randomized study comparing volar plate fixation with external fixation (with or without intra-focal fixation), 74 patients were studied. The researchers evaluated functional assessments (wrist range of motion, grip strength, and Michigan Hand Questionnaire) at each patient visit and measured radiographic assessment (radial inclination, volar tilt, ulnar variance, and articular congruity) at 12 months.

Results The grip strength of the VP group was significantly greater than that of the EF group at 3 and 6 months. The range of motion was significantly greater in the VP group than in the EF group at 3 months. There were no significant differences in the range of motion and grip strength between the 2 groups at 12 months. The Michigan Hand Questionnaire score was higher in the VP group than in the EF group at 3 months but was same at 12 months. There was no significant difference between groups with respect to volar tilt or radial inclination. The VP group showed superior radiologic outcomes in terms of the ulnar variance. One patient in the VP group and 3 in the EF group had an intra-articular stepoff deformity greater than 2 mm. This difference did not reach statistical significance.

Conclusions These results for functional recovery after distal radius surgery offer insight into treatment decisions and interpretations of treatment outcomes for patients with comminuted intra-articular distal radius fractures. Type of study/level of evidence Therapeutic I.

Original languageEnglish
Pages (from-to)34-41
Number of pages8
JournalJournal of Hand Surgery
Volume40
Issue number1
DOIs
StatePublished - 1 Jan 2015

Keywords

  • complex articular fracture
  • Distal radius fractures
  • external fixation
  • functional outcome
  • volar plating

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