Purpose
To compare the patient-reported, clinical, and radiographic outcome of 2 methods of
internal fixation in distal radius fractures.
Methods
Fifty patients, mean age 56 years (range, 21−69 years) with primarily nonreducible
or secondarily redisplaced distal radius fractures were randomized to open reduction
internal fixation using volar locking plates (n = 25) or fragment-specific fixation
(n = 25). The patients were assessed on grip strength, range of motion, patient-reported
outcome (Quick Disabilities of the Arm, Shoulder, and Hand), pain (visual analog scale), health-related
quality of life (Short Form-12 [SF-12]), and radiographic evaluation. Grip strength
at 12 months was the primary outcome measure.
Results
At 12 months, no difference was found in grip strength, which was 90% of the uninjured
side in the volar plate group and 87% in the fragment-specific fixation group. No differences
were found in range of motion and the median Quick Disabilities of the Arm, Shoulder, and Hand score was 5 in both groups. The overall
complication rate was significant, 21% in the volar locking plate group, compared
with 52% in the fragment-specific group.
Conclusions
In treatment of primarily nonreducible or secondarily redisplaced distal radius fractures,
volar locking plates and fragment-specific fixation both achieve good and similar
patient-reported outcomes, although more complications were recorded in the fragment-specific
group.
Type of study/level of evidence
Therapeutic II.
Key words
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Article info
Publication history
Published online: January 12, 2017
Accepted:
December 1,
2016
Received:
January 22,
2016
Footnotes
A.A. has been a paid instructor of 1 TriMed course. The rest of the authors declare they have no relevant conflicts of interest.
Identification
Copyright
© 2017 by the American Society for Surgery of the Hand. All rights reserved.
