Articular fractures of distal radius: Comparison of treatment and clinical and radiological outcomes with volar plate versus hoffmann bridging external fixator

The Wrist fractures are one of the most frequent traumatic pathologies. Surgery is now more commonly recommended for this type of fracture as a means to improve the outcome of patients. The objective of this study is to compare treatment with volar plate vs. external fixation in these types of fractures. A total of 158 consecutive patients who had been operated on for distal radius fractures with or without ulnar involvement, were included in this study. 109 were treated with a volar plate and 49 with Hoffmann II external fixator. The exclusion criteria were patients with a history of wrist fractures, with neurological diseases, pathological fractures and polytrauma patients. Clinical and radiographic results were evaluated in both groups of patients. Clinical parameters were: average flexion, average extension, average pronation and supination, and the average radial and ulnar deviation. The radiographic parameters that we considered were the radial tilt and ulnar variance. In both groups, we evaluated the clinical results with the DASH score and the Mayo-Wrist score. The unstable and intra-articular fractures of the distal radius can be treated with different methods, among which the most commonly used are the open reduction and internal fixation with plates or the synthesis with external fixation. Our study shows how both methods provide similar clinical and radiographic results, so the choice of which to use depends more on the surgeon's experience and the patient's compliance rather than on the type of fracture. © EuroMediterranean Biomedical Journal 2017

[1]  Vivekanandan,et al.  Complications of treating distal radius fractures with external fixation: A community experience , 2018 .

[2]  Seoung-Joon Lee,et al.  Clinical and radiologic factors affecting functional outcomes after volar locking plate fixation of dorsal angulated distal radius fractures. , 2016, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[3]  A. Ghiassi,et al.  Distal Radius Fractures: Approaches, Indications, and Techniques. , 2016, The Journal of hand surgery.

[4]  J. Goslings,et al.  Internal plate fixation versus plaster in displaced complete articular distal radius fractures, a randomised controlled trial , 2016, BMC Musculoskeletal Disorders.

[5]  J. Jupiter,et al.  Distal Radius Volar Rim Fracture Fixation Using DePuy-Synthes Volar Rim Plate , 2016, Journal of Wrist Surgery.

[6]  A. Johnstone,et al.  Volar locking plate fixation for distal radius fractures: Does age affect outcome? , 2016, Journal of orthopaedics.

[7]  A. Caraffa,et al.  The management of pin-care in external fixation technique: Povidone-Iodine versus sodium hypochlorite 0,05% (Amukina-Med®) medications , 2016 .

[8]  A. Caraffa,et al.  EPIDEMIOLOGY OF INJURIES AND DISEASES DUE TO OVERUSE IN RUGBY: OBSERVATIONAL STUDY OF THE PLAYERS OF “CUS PERUGIA RUGBY” , 2016 .

[9]  P. Biberthaler,et al.  Pronator quadratus repair after volar plating of distal radius fractures or not? Results of a prospective randomized trial , 2015, European Journal of Medical Research.

[10]  M. Rosenwasser,et al.  The Epidemiology of Upper Extremity Fractures in the United States, 2009 , 2015, Journal of orthopaedic trauma.

[11]  L. Obert,et al.  Plate fixation of distal radius fracture and related complications , 2015, European Journal of Orthopaedic Surgery & Traumatology.

[12]  Sanjay Meena,et al.  Fractures of Distal Radius: An Overview , 2014, Journal of family medicine and primary care.

[13]  J. Goslings,et al.  Incidence and characteristics of distal radial fractures in an urban population in The Netherlands , 2014, European Journal of Trauma and Emergency Surgery.

[14]  R. Kaufmann,et al.  Distal radius fractures: current concepts. , 2012, The Journal of hand surgery.

[15]  S. Kini,et al.  Loss of correction in unstable comminuted distal radius fractures with external fixation and bone grafting -a long term followup study , 2011, Journal of orthopaedic surgery and research.

[16]  F. Pogliacomi,et al.  Complex fractures of the distal radius treated with angular stability plates , 2009, La Chirurgia degli organi di movimento.

[17]  I. Atroshi,et al.  Incidence and characteristics of distal radius fractures in a southern Swedish region , 2007, BMC musculoskeletal disorders.

[18]  H. Reilmann,et al.  [Results after palmar plate-osteosynthesis with angularly stable T-plate in 100 distal radius fractures: a prospective study]. , 2003, Der Unfallchirurg.

[19]  A. Joist,et al.  [The treatment of unstable fractures of the distal radius using a bridging external fixator. Results from a long-term evaluation]. , 1999, Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen.

[20]  S. Fruensgaard,et al.  Treatment of unstable Colles' fractures by external fixation. , 1989, Journal of hand surgery.