Volar-locking plate versus external fixator in the management of distal radius fractures: an isokinetic study

Abstract

BACKGROUND: The aim of this study was to compare the clinical and isokinetic evaluation of distal radius fractures treated by volar locking plate (VLP) and external fixator. METHODS: The study included fifty patients with distal radius fracture type C1/C2/C3. Twenty-seven patients (12 men, 15 women; mean age 49.5±4.42) underwent open reduction and VLP fixation, and 23 patients (10 men, 13 women; 52.1±4.6) underwent closed reduction and external fixation. The follow-up period was at least 12 months and the mean following time was 13.5±1.02 (12–15) months. The functional parameters measured were range of motion (ROM) and grip strength. Radiographic parameters (radial inclination, palmar tilt, and radial height) and isokinetic evaluation were measured at the 6 months and at the final follow-up after surgery. The isokinetic test was done at the speed of 60º/s. The non-fractured arm was tested first and all results were also expressed as a percentage of that on the normal side. Wrist scores according to the disability of the arm, shoulder, and hand (DASH) questionnaire were used. RESULTS: The DASH scores, grip strength, and palmar flexion were better in VLP group at the 6 months (p<0.05). However, there were no differences between two groups at the one year (p=0.79). Isokinetıc evaluation of the VLP showed that peak pronatıon torque and total pronation work were better than external fıxatıon at the 6 month (p<0.05). At the final of follow-up was seen no significant differences between two groups (p=0.11). CONCLUSION: We looked at external fixation and locked volar plates in a prospective study and we found an improved range of movement and isokinetic evaluation outcome at 6 months after locked plating, but there were no differences between two groups at the final of follow-up. Our study showed no evidence for the superiority of one treatment over the other at the final follow-up.

Surgical options for distal radius fractures of type C in elderly patients over 65 years old: a comparison of external fixation with Kirschner wires and volar locking plate

“…In this study, both groups of patients had good fracture healing and no related complications such as nonunion or osteomyelitis. The advantages of EF over VLP, such as less bleeding, shorter surgery time, and no incision, cannot be ignored in line with modern minimally invasive surgery [ 26 ]. At the same time, for patients with widely comminuted C2 and C3 DRF, the use of EF treatment has the advantages of shorter surgery time and equivalent functional outcomes [ 26 , 27 ].…”

“…The advantages of EF over VLP, such as less bleeding, shorter surgery time, and no incision, cannot be ignored in line with modern minimally invasive surgery [ 26 ]. At the same time, for patients with widely comminuted C2 and C3 DRF, the use of EF treatment has the advantages of shorter surgery time and equivalent functional outcomes [ 26 , 27 ]. Therefore, our research group believes that in clinical practice, external fixation should be the preferred treatment for distal radius fractures in patients with poor cardiopulmonary function who cannot tolerate long surgeries, as well as for patients with severely comminuted C2 and C3 DRF.…”

Surgical options for distal radius fractures in elderly patients over 65 years old: A comparison of external fixation and volar locking plate

“…In this study, both groups of patients had good fracture healing and no related complications such as nonunion or osteomyelitis. The advantages of EF over VLP, such as less bleeding, shorter surgery time, and no incision, cannot be ignored in line with modern minimally invasive surgery [25]. At the same time, for patients with widely comminuted C2 and C3 DRF, the use of EF treatment has the advantages of shorter surgery time and equivalent functional outcomes [25,26].…”

“…The advantages of EF over VLP, such as less bleeding, shorter surgery time, and no incision, cannot be ignored in line with modern minimally invasive surgery [25]. At the same time, for patients with widely comminuted C2 and C3 DRF, the use of EF treatment has the advantages of shorter surgery time and equivalent functional outcomes [25,26]. Therefore, our research group believes that in clinical practice, external xation should be the preferred treatment for distal radius fractures in patients with poor cardiopulmonary function who cannot tolerate long surgeries, as well as for patients with severely comminuted C2 and C3 DRF.…”

Radiolog&#305;cal Evaluation of Volar Cortical Angle in the Anatolian Population

“…Distal radius fractures, which constitute 44 % of all forearm and hand fractures, are the most common type of upper limb fractures. One out of six patients presenting to the emergency department with a bone fracture has a distal radius fracture (Dündar et al, 2022;Abdel-Wahed et al, 2022). However, despite the high incidence of distal radius fractures, there is still no consensus on the optimal treatment strategy.…”