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Minerva Orthopedics 2022 June;73(3):299-308

DOI: 10.23736/S2784-8469.21.04139-0


language: English

A short-term prospective study of intra-articular distal radius fracture fixation: comparison between external fixation and internal fixation

Darshan KUMAR, Ashwini V. RAJAN , Naresh SHETTY

Department of Orthopedics, MS Ramaiah Medical College and Hospitals, Bengaluru, India

BACKGROUND: Intra-articular distal radius fractures are notorious in progressing to malunion when mismanaged. Despite the availability of extensive research material, a lot of controversies still exist when it comes to narrowing down to one reliable treatment approach in intraarticular distal radius fractures. The aim of this study is to compare the clinical, radiological, and functional outcomes between external fixation and internal fixation in the management of intra-articular distal radius fractures.
METHODS: All patients between 18-50 years of age with intra-articular distal end radius fractures were studied from September 2016 to July 2018. Patients were randomly grouped into group 1, closed reduction and external fixation with spanning external fixator (ExFix) and group 2, open reduction and internal fixation with volar locking plate (VLP). Clinical, radiological, and functional outcomes were evaluated preoperatively and postoperatively at 6, 12, 24, and 48 weeks. Statistical evaluation was conducted using R software v. 4.0.1 and Microsoft Excel 2016.
RESULTS: A progressive increase of the mean values at subsequent follow-ups was observed in both the groups. The mean values of radiological parameters (radial inclination and radial height) and all clinical parameters were significantly better in the VLP group (P<0.001). Significant differences were found in the functional outcomes (DASH score and Mayo wrist score) at time periods (P<0.001); however, scores were better in VLP compared to the ExFix group.
CONCLUSIONS: Internal fixation using volar locking plate provided better outcomes in addition to reduced complications and rehabilitation duration compared to external fixation in the management of distal radius intra-articular fractures.

KEY WORDS: Radius fractures, External fixator, Fracture fixation, Open fracture reduction

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