Clinico- Radiological and functional outcome after surgical fixation of intraarticular fractures of distal end of radius by external fixator verses locked volar plate: A prospective randomised study

Abstract

Background: Intra-articular fractures of the distal radius represent high energy, complex, unstable injuries and the optimal method of treatment remains controversial. Material & Methods: Fifteen patients underwent open reduction and palmar locking plate fixation, and 15 patients underwent closed reduction and K-wire augmented external fixation on random basis. For functional and radiological assessments, Demerit score were used and grip strength was measured using a Dynamometer. Subjective functional assessment was made using the DASH scale. The follow-up period was at least 6 months. Statistics: Observational descriptive statistics, Student's unpaired 't' test and Chi-square test. Results: The radiological parameters at three and six months were better in patients treated with plate group. Patients in the plate group had better functional outcome score (DASH). The findings were statistically significant at three months period but did not show any significance at six months period. Functionally and radiologically (DEMERIT Score) plate group had better score. The findings were statistically significant in three months period, but did not show any significance at six months period. Patients in the plate group showed better grip strength. In patients whose right hand was involved the findings were statistically significant at three months but at six months there was no statistical significance. Conclusion: Treatment with open reduction and internal fixation for intra articular fractures of distal end of radius provides good radiological results. However, objective and subjective functional assessment showed no significant superiority between external fixation and volar plate fixation at 6 months follow-up.