Unstable Distal Radial Fractures Treated with External Fixation, a Radial Column Plate, or a Volar Plate

Wei, David H.; Raizman, Noah; Bottino, Clement J.; Jobin, Charles M.; Strauch, Robert J.; Rosenwasser, Melvin P.

doi:10.2106/jbjs.h.00722

Cited by 182 publications

(130 citation statements)

References 31 publications

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“…At three months, the patients with a volar plate demonstrated a DASH score that was significantly better than the patients treated with external fixation (p = 0.028). At six months and one year, both groups had DASH scores comparable with those for the normal population [14]. The same findings were seen in a study by A Gereli et al The mean Quick DASH score was 2.4±3.0 in the palmar locking plate group, and 2.9±5.4 in the external fixation group [13].…”

Section: Discussionsupporting

confidence: 80%

Clinico- Radiological and functional outcome after surgical fixation of intraarticular fractures of distal end of radius by external fixator verses locked volar plate: A prospective randomised study

Pradhan¹,

Agrawal²,

Prasad³

et al. 2013

IOSR-JDMS

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Section: Discussionsupporting

confidence: 80%

Clinico- Radiological and functional outcome after surgical fixation of intraarticular fractures of distal end of radius by external fixator verses locked volar plate: A prospective randomised study

Pradhan¹,

Agrawal²,

Prasad³

et al. 2013

IOSR-JDMS

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“…Previous literature has estimated a 10-point difference in the DASH score to be clinically meaningful [13,18]. Recent studies administering the DASH to patients with distal radius fractures have shown that a standard deviation of DASH scores ranging from 5 to 10 points allowed for an accurate power analysis [6,34,37,42]. Using these parameters in the literature-a mean difference of 10 points, and a standard deviation of 10-we determined with an alpha of 0.05 a minimum of 17 patients per group were required to detect a significant difference with a two-tailed independent samples t test between groups.…”

Section: Discussionmentioning

confidence: 99%

A Functional Outcomes Survey of Elderly Patients who Sustained Distal Radius Fractures

Amorosa

Vitale

Brown

et al. 2011

Hand (New York, N,Y.)

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Purpose This study aims to examine the subjective functional outcomes of patients 70 years or older who sustained distal radius fractures through the use of the Disability of the Arm, Shoulder, and Hand (DASH) and Short Form-8 Health (SF-8) surveys. Methods Patients at least 70 years old with a distal radius fracture between 2000 and 2004 were identified and their charts reviewed. They were contacted to answer the DASH and SF-8 surveys. The radiographic injury parameters examined were articular stepoff greater than 2 mm, dorsal tilt on the lateral radiograph, ulnar variance, and presence of an ulnar styloid fracture. Results Fifty-eight patients answered the DASH and SF-8 surveys. The mean age at the time of injury in the survey group was 78 years old (range 70-94 years). Mean follow-up period was 33 months (range 13-65 months). Average DASH and SF-8 scores were 22.3 (SD 22.4) and 31.5 (SD 6.9), respectively. DASH scores were inversely correlated with SF-8 scores (R=−0.65, p<0.01). Patients who sustained an associated ulnar styloid fracture demonstrated worse DASH scores than those without an ulnar styloid fracture (presence of ulnar styloid fracture: mean DASH 26.2, no ulnar styloid fracture: mean DASH 12.9, p=0.04). There were no significant differences in functional outcome for any other radiographic parameters assessed. Males had statistically better DASH scores than the females (males: mean DASH 6.9, females: mean DASH 24.4, p= 0.003). No difference was found in functional outcome scores among different treatment groups. Conclusion In elderly patients with distal radius fractures, the only radiographic parameter we found that affects functional outcome is an associated ulnar styloid fracture. Additionally, females had worse functional outcomes than males.

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“…This was comparable with results obtained by David and Robert et al, in which they concluded that use of a volar plate predictably leads to better patientreported outcomes (DASH scores) in the first three months after fixation. 7,12 However, at six months and one year, the outcomes were found to be excellent, with minimal differences among them in terms of strength, motion, and radiographic alignment. This result also matches with the result obtained by Rozental et al that there is no difference between the two treatment groups with regards to functional or radiographic outcomes, at 1 year after the injury.…”

Section: Discussionmentioning

confidence: 93%

Comparison study for internal and external modes of fixation for fractures of distal end radius

Shah

et al. 2017

Int J Res Orthop

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Background: Fractures of the distal radius continue to be one of the most common skeletal injuries. The methods which are commonly practiced are closed manipulation and plaster cast, pins and plaster, percutaneous pinning, external fixation and open reduction and internal fixation with or without bone graft. Surgeons are increasingly faced with the dilemma of when to consider operative management and when cast immobilization is the optimal treatment.Methods: 47 cases of distal end radius fractures were operated in the orthopedic department of a tertiary care centre. The purpose of the present study was to compare the results of external and internal fixation methods for the treatment of fractures of distal end of radius. Patients operated by external fixation were classified as Group A and those operated by internal fixation were classified as group B. Patients were classified according to AO Classification. Patients were followed at regular intervals depending on the case and time of operation and evaluated by Gartland and Werley score.Results: In our study, 29 patients were of extraarticular type, of which 86.20% had an excellent score and 18 patients were of intraarticular type, of which 83.33% had an excellent score. But when compared to groups A and B, the percentage of excellent score obtained in group B was more than that in group A in both extraarticular and intraarticular fractures. Yuan-kun et al did a study on intraarticular distal end radius fractures and evaluated the patients by Gartland and Werley point system, concluding that plating gives better results than external fixation supplemented by K wiring. Conclusions: We concluded that no method of fixation can be said superior to the other. Each method has fracture-specific indication. The results of open reduction and internal fixation can be better than external fixation in initial months, but in the long run, both the methods can have excellent score, provided the fixation is good and properly indicated.

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Unstable Distal Radial Fractures Treated with External Fixation, a Radial Column Plate, or a Volar Plate

Cited by 182 publications

References 31 publications

Clinico- Radiological and functional outcome after surgical fixation of intraarticular fractures of distal end of radius by external fixator verses locked volar plate: A prospective randomised study

Clinico- Radiological and functional outcome after surgical fixation of intraarticular fractures of distal end of radius by external fixator verses locked volar plate: A prospective randomised study

A Functional Outcomes Survey of Elderly Patients who Sustained Distal Radius Fractures

Comparison study for internal and external modes of fixation for fractures of distal end radius

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