Wrist function recovers more rapidly after volar locked plating than after external fixation but the outcomes are similar after 1 year A randomized study of 63 patients with a dorsally displaced fracture of the distal radius

• Published in: Acta orthopaedica Vol. 82; no. 1; pp. 76 - 81
• Main Authors: Wilcke, Maria K T, Abbaszadegan, Hassan, Adolphson, Per Y
• Format: Journal Article
• Language: English
• Published: Basingstoke Taylor & Francis 01.02.2011; Informa Healthcare
• Subjects: Biological and medical sciences; Diseases of the osteoarticular system; Injuries of the limb. Injuries of the spine; Medical sciences; Traumas. Diseases due to physical agents; Human; Wrist; Fracture dislocation; Radius; Fixation; Prognosis; Orthopedics; Diseases of the osteoarticular system; External; Bone
• ISSN: 1745-3674; 1745-3682
• DOI: 10.3109/17453674.2011.552781

Background and purpose Promising results have been reported after volar locked plating of unstable dorsally displaced distal radius fractures. We investigated whether volar locked plating results in better patient-perceived, objective functional and radiographic outcomes compared to the less invasive external fixation. Patients and methods 63 patients under 70 years of age, with an unstable extra-articular or non-comminuted intra-articular dorsally displaced distal radius fracture, were randomized to volar locked plating (n = 33) or bridging external fixation. Patient-perceived outcome was assessed with the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire and the Patient-Rated Wrist Evaluation (PRWE) questionnaire. Results At 3 and 6 months, the volar plate group had better DASH and PRWE scores but at 12 months the scores were similar. Objective function, measured as grip strength and range of movement, was superior in the volar plate group but the differences diminished and were small at 12 months. Axial length and volar tilt were retained slightly better in the volar plate group. Interpretation Volar plate fixation is more advantageous than external fixation, in the early rehabilitation period.