Ligamentotaxis supplemented by K wires fixation versus volar plate and screws fixation for management of unstable fractures of the distal radius

Abstract

Background: Fractures of the distal radius was found to be one of the most common skeletal injuries treated by orthopedic or trauma surgeons Objectives: To evaluate the outcome after operative treatment of unstable distal radius fractures to obtain good alignment through different methods of treatment as closed reduction and pinning, bridging and open reduction with volar plate-and-screw fixation. Patients and methods: Our study was a prospective, randomized trial conducted between 2018 and 2019 including 40 patients with displaced, unstable fractures of the distal radius .They were randomized to be managed either by ligamentotaxis supplemented with K-wire fixation or with volar plate fixation with similarity of both groups in the compared variables including age, gender ,mode of trauma , medical co-morbidities and the pattern of fracture. Results: The study was conducted on 40 patients with the mean age of ligamentotaxis group 38.9 years (Range 22-57), while the plating group was 39.45 years (Range 29-51). More than half of patients underwent ligamentotaxis were males and 60% of patients in the plating group were females .Patients in ligamentotaxis group had either road traffic accident or fell on ground with almost equal proportions, but in the plating group falling on ground was the most common. AO fracture type B was the most common among our sample. No statistically significant difference was found between both groups neither at 3 months nor at 6 months follow up. However, the Mayo score showed statistically significant improvement along the follow up Conclusions: We concluded that there is no evidence for the superiority of one treatment over the other either using locking plate and screws or ligamentotaxis supplemented by k wires.

Keywords

• ligamentotaxis k wires volar plate unstable fractures