Comparative Study of Surgical Outcome of Distal Radius Fracture Treated By External Fixator and Plating

Abstract

Background and Objective:Distal radius fracture is the most common fracture we treat, The management has undergone an extraordinary evolution over the preceding twenty years. Universal cast treatment gave to the neutarlization with a bridging external fixator, which in turn was replaced by dorsal buttress plating. The technical advance of palmar locking plating has again changed the management of this fracture in a real and seemingly permanent way. There was no consensus regarding the management of a particular type. A randomized comparative study was undertaken to study the functional outcome between the closed reduction external fixation over volar locking plating . Methods:60 patients with distal radius fractures were selected who were who were admitted in Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Patients were randomized into 2 groups , one group treated with closed reduction external fixation and other group with Open reduction with plating in each group with 30 patients. Post operatively follow up was done for 6 month and functional outcome was assessed using Green &O’brien scoring. Result:The study comprised of 34 males and 26 females aged between 18-65 years, with mean age of 35. 26 years. Functional outcome score using Green &O’brien scoring on follow up we got 35% excellent results, 39 % good results, 25 % fair results,5% poor results and 13% with complications. Conclusion:Open Reduction with Volar locking Plate provided stable anatomical construct, Restoration of anatomy, early mobilization, Complications were minimal and presented on follow up were wrist stiffness. External Fixation provide stable fixation in par with open reduction and plating but had more complications such as wrist stiffness and pin tract infections, delayed healing. The conclusion were based on this short term study hence both cannot be compared and needs long term study.