A Comparative Study of Distal Radius Fractures Managed by Ligamentotaxis Versus Buttress Plating

Abstract

ABSTRACT:The fracture of the distal end of radius was first identified by Sir Abraham Colles. With the increase in high velocity trauma, there has been an observed increase in the incidence and fracture patterns of the distal radius. MATERIALS AND METHODS:We conducted a prospective on distal radius fractures with 132 patients. All cases of distal radius fractures were considered between the age group of 20 and 70 years. Frykmans classification was used to classify the fractures. The patients were followed up every three weeks following surgery.The patients were assessed subjectively and objectively using New York Hospital Wrist Scoring system. RESULTS: Our study showed that anatomical and functional results were excellent in 35.7% of the patients versus 25% of those patients treated by external fixation. 30.3% of our patients managed by internal fixation had good functional outcome at the end of one year follow-up versus 43.4% of them treated with external fixation. 25% of patients treated by internal fixation had fair results while 13.1% of the patients managed by external fixation had fair results. Poor results were observed in 8.9% of patients managed by internal fixation as compared to18.4% of them managed by external fixator. The fair and poor results were due to inability to maintain accurate articular reduction and congruity of the distal radius using the external fixator. Potential complications like pin tract infection and loosening could also be attributed towards poor scores while using external fixation. CONCLUSION: The incidence of complications and poor results in internal fixation are fewer when compared to external fixation in this study. Patients managed with buttress plating had better functional outcome and returned to their daily routine earlier than those patients managed with ligamentotaxis.

Study on functional outcome of distal radius intra-articular fractures managed by ligamentotaxis: a cross sectional study

“…15% of study population were below 30 years of age and 25% above 50 years. Similar results were observed in studies done by Anil et al and Supreeth et al 10,11 In a study done by Manoj et al in Chennai, the proportion of male and female were more or less equal. 12 Around 67% of the study population had type III or type IV fracture according to Frykman's classification.…”

“…12 Around 67% of the study population had type III or type IV fracture according to Frykman's classification. Similar results were observed in studies done by Supreeth et al and Manoj et al 11,12 In a study done by Viswanathan et al, majority (66%) of the fractures were between type VI and VIII. 1 The use of external fixation and pinning has demonstrated successful outcome in multiple studies.…”

“…Many studies reported only between 67-76% better prognosis. 2,4,11,12 Though the difference in mean Mayo wrist score was 7.2, there is no significant difference between the two means by t-test which implies that functionally there is not much difference after the procedure.…”

Management of unstable distal radius fractures by ligamentotaxis with external fixation

“…Deepak CD et al, obtained excellent outcome in 15% cases, good results in 60% cases, fair results in 20% cases and 5% cases had poor results [14] . Study by Supreeth Nekkanti et al, obtained excellent results in 25% cases, good results in 43.4% cases, fair results in 13.1% cases and poor results in 18.4% [15] . Whereas in the present study, 21.8% cases had excellent results, 40.6% cases had good results, 28.1% cases had moderate results and 9.3% cases had poor results when treated with ligamentotaxis with external fixation.…”

“…In males, majority cases were in between 41-50 years in both sexes (males 33.3%, females 28.5%) (Table 1). Study by Ashok K Syam et al, included cases between age group 23-79 years with mean age 42.84 and males [15] were more than female cases (04) [11] . Study by Vishwanath C et al, on 50 cases found 34% cases were in between age group 20-30 years, 26% in between 41-50 years and 24% in between 31-40 years with mean age 54 years and male predominance (76%) [12] .…”