Comparison of Functional Outcome Between Early and Delayed Internal Fixation Using Volar Locking Plate for Distal Radius Fractures

Abstract

: The purpose of this study was to assess the effect of timing (Early (E) group vs Delayed (D) group) of internal fixation for distal radius fractures on forearm and wrist function in patients who underwent the surgery. The subjects were one hundred six patients who had extra-articular fractures of the dorsally displaced distal radius and were treated with a volar locking plate. The subjects were divided into two groups: E group (Operation on the day of injury or the next day, n = 76 ; and the D group (Operation at 7 days after injury or later, n = 30). Follow-up examinations conducted at 4, 12, and 48 weeks after surgery included measurements of wrist and forearm ranges of motion (ROM), measurement of grip strength (GS), Disability of the Arm, Shoulder and Hand score (DASH), and complications, retrospectively. The patients in both groups improved significantly with respect to ROM, GS, and DASH. At 4 weeks, the patients in the E group had better forearm motion, At 4 and 12 weeks, those who had undergone early surgery had significantly better wrist motion, GS and DASH. At 48 weeks, there were no differences between the groups in ROM, GS, or DASH. Patients with dorsally displaced extra-articular fractures of the distal radius can expect to have better short-term outcomes with early treatment, open reduction and internal fixation using a volar locking plates.

Early palmar plate fixation of distal radius fractures may benefit patients aged 50 years or older: a randomized trial comparing 2 different treatment protocols

“…Yamashita et al. (2015) performed a retrospective study of extra-articular DRFs, and found no difference in functional results between early and delayed fixation at 1 year of follow-up. Our study included intra-articular fractures and had a longer follow-up time, possibly explaining the difference.…”

Development and Trial of a Prototype Device for Sensorimotor Therapy in Patients with Distal Radius Fractures

“…The primary outcome was RoM [10,22]. The motion angles of the wrist and forearm on the injured side were measured by an occupational therapist who was certified at the Hand Surgery Evaluation Method Workshop in Japan.…”

“…We examined the feasibility of Ghost for clinical use during a preliminary study involving a small sample. Age and body mass index (BMI) were selected as independent variables for stratified analysis, as these variables have been found to affect ROM improvements with VR therapy in DRF patients in previous reports [10,22]. For instance, treatment outcomes with the VR system are affected by age and cognitive function [25].…”

Effect of delayed distal radius fracture fixation on the difficulty of surgical operation

“…Early surgery shows superior outcomes and is recommended in most cases [ 8 , 9 , 10 , 11 ]. However, some studies have shown that delayed fixation affects only short-term outcomes and is indistinguishable in long-term functional results [ 12 , 13 ]. Moreover, there is no information about the effect of delayed fracture fixation on the difficulty of intraoperative surgical operation and acute postoperative periods.…”