Comparison of 2-year clinical and radiological outcomes between volar plating and external fixation with additional K-wires for AO Type C distal radius fractures

Çiçekli, Özgür; Sukur, Erhan; Kochai, Alauddin; Bayam, Levent; Bingöl, İzzet; Özdemir, Uğur

doi:10.3906/sag-1811-73

Cited by 2 publications

(2 citation statements)

References 31 publications

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“…[ 3 , 15 ] In a study in which 21 AO type C distal radius fractures were treated with a BEF, one superficial infection and eight complex regional pain syndromes (CRPSs) developed, mean wrist flexion was 51.5°, extension was 46.8°, ulnar deviation was 16.3°, radial deviation was 12.7°, mean DASH score was 17.6, and mean grip strength was 35.1 kg. [ 16 ] Sharma et al[ 17 ] applied external fixator to 15 intraarticular distal radius fractures, obtained 63° flexion, 60° extension, 69° supination, 66° pronation, 25° ulnar deviation, and 14° radial deviation. According to the modified Green and O'Brien scoring system, one excellent, five good, five fair, and four poor results were obtained and one pin tract infection was detected.…”

Section: Discussionmentioning

confidence: 99%

Combined palmar and dorsal plating of four-part distal radius fractures: Our clinical and radiological results

Kibar

2021

Jt Dis Relat Surg

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Objectives This study aims to investigate the radiological and clinical outcomes of four-part intraarticular distal radius fractures treated with a volar anatomically locked plate and 2 mm low-profile plates using both the volar and dorsal approaches. Patients and methods This retrospective study included 20 patients (8 males, 12 females; mean age 47±12.1; range, 25 to 67 years) who received open reduction and internal fixation with combined volar and dorsal plating to treat complex four-part distal radius fractures (shaft, radial styloid area, dorsal medial facet, volar medial facet) between May 2016 and January 2019. According to Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification, all fractures were 2R3-C3. According to Melone classification, one fracture was type 1, seven fractures were type 2a, three were type 2b, three were type 3 and six were type 4. The mean follow-up time was 21±7.5 (range, 12 to 36) months. Results Union was achieved in all fractures. The mean tourniquet time was 103±12 (range, 90 to 130) minutes. The mean Disabilities of the Arm, Shoulder, and Hand questionnaire score was 10±9, and the mean Visual Analog Scale score was 2.1±0.9. According to Mayo wrist score, five patients had excellent, six had good, six had satisfactory and three had poor results. The mean grip strength was 25.2±9.2 (range, 15 to 40) kg and 78% of opposite side. Mean wrist flexion was 48.7°±15.3° (range, 30° to 80°), extension was 52.2°±17.2° (range, 25° to 80°), radio-ulnar deviation arc was 40.7°±6.9° (range, 30° to 55°), and mean forearm rotation arc was 152.3°±11° (range, 130° to 170°). Conclusion Plating method with a dual approach may be an alternative for four-part intraarticular distal radius fractures given its early mobility advantage and satisfactory functional and radiological results.

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Section: Discussionmentioning

confidence: 99%

Combined palmar and dorsal plating of four-part distal radius fractures: Our clinical and radiological results

Kibar

2021

Jt Dis Relat Surg

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“…Distal radius fractures are frequent orthopaedic injuries, comprising the most common upper extremity fracture. [1][2][3][4][5][6] There are many effective treatment methods, but little consensus on which volar plating is most successful. Volar plating is widely used because of its stability, early movement, and quick return to activity.…”

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Interventions for Distal Radius Fractures: A Meta-analysis of Comparison Studies

et al. 2021

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Background Distal radius fractures are one of the most frequent orthopaedic injuries. There are many effective treatment methods, such as volar plate, dorsal plate, percutaneous pins, external fixation, and casting; however, comparison of the treatment outcomes has not been thoroughly investigated. Our purpose is to determine if volar plating is the superior treatment method for distal radius fractures. We will address this through the following questions: First, is volar plating superior to dorsal plating, percutaneous pins, external fixation, or casting in terms of reported complications? Second, does volar plating produce superior functional outcomes to dorsal plating, percutaneous pins, external fixation, or casting? Third, are the radiographic outcomes superior for volar plating when compared with dorsal plating, percutaneous pins, external fixation, or casting? Methods MEDLINE, Academic Search Ultimate, Academic Search Complete, CINAHL Plus, and JSTOR databases, as well as manual search, were used to identify papers comparing complications and functional results of volar plating to other treatment methods for distal radius fractures published after the year 2000. Complication data and function scores were recorded. Risk of bias was assessed using the Cochrane Risk of Bias Tool and data was analyzed for meta-analysis using Cochrane ReviewManager software. Results Compared with dorsal plate, volar plate performed significantly better in Gartland and Werley score. Volar plating outperformed percutaneous pins for loss of reduction, infection, Disabilities of the Arm, Shoulder, and Hand (DASH) score, and ulnar deviation. Loss of reduction, malunion, Patient Related Wrist Evaluation (PRWE) score, DASH score, grip strength, ulnar deviation, and supination were significantly better for volar plating when compared with casting. When compared with external fixation, volar plating had significantly less cases of infection, lower QuickDASH score, and higher range of motion for flexion, pronation, and supination. All other complication and functional outcomes were not significantly different. Conclusions Distal radius fractures treated with volar plating showed relatively better measures of complications, function scores, and range of motion than other treatment methods; however, there was no significant difference in healing time when compared with percutaneous pins. More studies are needed to compare the rest of the treatment methods with each other.

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Comparison of 2-year clinical and radiological outcomes between volar plating and external fixation with additional K-wires for AO Type C distal radius fractures

Cited by 2 publications

References 31 publications

Combined palmar and dorsal plating of four-part distal radius fractures: Our clinical and radiological results

Combined palmar and dorsal plating of four-part distal radius fractures: Our clinical and radiological results

Interventions for Distal Radius Fractures: A Meta-analysis of Comparison Studies

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