A comparative study of distal third radius and ulna fractures treated with locking plate and non-locking plate in geriatric age group

Abstract

Background: Fractures of radius and ulna are amongst the leading injuries in upper extremity in geriatric age group. Associated rotational instability of forearm bones in such fractures renders them suitable for operative fixation. Non-the less conservative management has also been employed in such injuries. We conducted this study to analyze and compare the outcomes of using Locking plate and Non-locking plates for internal fixation in geriatric population for distal 1/3 rd shaft radius and ulna fractures in terms of fracture union, range of motion and functional outcome. Methods: Aprospective study of 20 patients with distal third radius and ulna fracture was conducted with 10 patients managed with locking 3.5 mm Dynamic Compression Plate and 10 with non-locking 3.5 mm Dynamic Compression Plate. All patients with extra-articular fractures were selected for this study and were randomly chosen for each procedure. They were followed up regularly at 3 weeks, 6 weeks and 12 weeks for time of union, wrist flexion, elbow flexion, supination, pronation and functional outcome. Results: There were a total of 13 males and 7 females. Mean time for radiological union was 5.8 weeks for Locking plate, 8 weeks for non-locking plate. Mean Flexion/Extension at elbow was 134 o /140 o for locking plate, 132 o /139 o for non-locking plate. Average supination/pronation was 61 o /66.4 o for locking plate, 57 o /61.8 o for non-locking plate. Mean duration for surgery was 75.25 minutes for locking plate, 75.70 minutes for non-locking plate. Conclusion: Open reduction and internal fixation with locking plating can be considered as the treatment of choice when considering fixation of distal third Radius and Ulna fractures in geriatric age group.