Comparison between volar plating and external fixation augmented by Kirshner wires in comminuted distal radial fractures

Abstract

Background Volar locking plate (VLP) has gained the most popularity in the treatment of distal radius fractures due to its superior biomechanical property. In contrast, external fixation (EF) is not so extensively used. The aim of this study was to find what procedure is better in the management and achieves favorable outcomes in patients with comminuted distal radial fractures. Patient and methods This study included 30 patients with distal radial fractures AO types A3, C2, C3 in which 15 ubjects were managed with open reduction and internal fixation by volar plate, and another 15 were managed with external fixation augmented by K-wires. The minimum duration of follow-up in our study was six months. Results Patients treated with external fixation augmented by K-wires had grip strength range 15-27, patients treated with volar plating had grip strength range 8-27. There was no significant statistical difference between 2 groups regarding extension. In Group A Mann- Whitney test revealed that Gartland-Werely score had negative correlation with affected hand. In Group B the correlation was positive with AO/ OTA classification only and negative with affected hand and ulnar styloid fracture but also not statistically significant between Quick-DASH score with affected hand, AO/OTA classification and ulnar styloid fracture. Conclusion Both volar plating and external fixation augmented by K-wires are treatment choices for distal radius fractures. Whereas external fixation maintains a significant role in the treatment of distal radius fractures, ORIF with locked volar plating has changed the way many surgeons treat certain types of distal radius fractures.

Keywords

• volar plating
• external fixation
• radial fractures
• dash score