External Fixation Versus Volar Locking Plate for Unstable Dorsally Displaced Distal Radius Fractures—A 3-Year Follow-Up of a Randomized Controlled Study

  • Jenny Saving
    Correspondence
    Corresponding author: Jenny Saving, MD, Department of Orthopaedics, Södersjukhuset Hospital, SE—118 83 Stockholm, Sweden.
    Affiliations
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden

    Department of Orthopaedics, Södersjukhuset Hospital, Stockholm, Sweden
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  • Anders Enocson
    Affiliations
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden

    Department of Molecular Medicine and Surgery, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
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  • Sari Ponzer
    Affiliations
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden

    Department of Orthopaedics, Södersjukhuset Hospital, Stockholm, Sweden
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  • Cecilia Mellstrand Navarro
    Affiliations
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden

    Department of Hand Surgery, Södersjukhuset Hospital, Stockholm, Sweden
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Published:November 09, 2018DOI:https://doi.org/10.1016/j.jhsa.2018.09.015

      Purpose

      To determine if a volar locking plate (VLP) is superior to external fixation (EF) 3 years after surgery for unstable, dorsally displaced, distal radius fractures caused by low-energy injury in patients 50 to 74 years of age.

      Methods

      During 2009 to 2013, 140 patients with an unstable dorsally displaced distal radius fracture were randomized to either VLP or EF. One hundred eighteen patients (EF 56, VLP 62) were available for a 3-year follow-up. The primary outcome was the Disabilities of the Arm, Shoulder, and Hand (DASH) score at 3 years. Secondary outcomes were Patient-Related Wrist Evaluation (PRWE) score, EuroQol-5 Dimensions (EQ-5D) score, range of motion (ROM), grip strength, and radiological signs of osteoarthritis (OA) at 3 years. Moreover, reoperations and minor complications during the first 3 years were recorded.

      Results

      There were no differences regarding DASH, PRWE, EQ-5D, ROM or grip strength. The reoperation rate was 21% (13 of 62) in the VLP group compared with 14% (8 of 56) in the EF group. The OA rate was 42% (25 of 59) in the VLP group compared with 28% (15 of 53) in the EF group.

      Conclusions

      Three years after surgery for unstable dorsally displaced distal radius fractures, the clinical and radiological results for VLP and EF were comparable.

      Type of study/level of evidence

      Therapeutic II.

      Key words

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