Volar Locking Plates Versus External Fixation and Adjuvant Pin Fixation in Unstable Distal Radius Fractures: A Randomized, Controlled Study

External Fixation and Adjuvant Pins Versus Volar Locking Plate Fixation in Unstable Distal Radius Fractures: A Randomized, Controlled Study With a 5-Year Follow-Up

“…2 Several studies have demonstrated that open reduction internal fixation (ORIF) is superior to external fixation (EF) in the short term 3e5 ; and in their meta-analysis, Li-Hai et al 6 toward overall better Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores by the 12-month follow-up after using VLP. The 1-year results of our study have previously been reported, 7 and the findings included a higher Mayo wrist score (90 vs 85; P ¼ .02), better supination (89 vs 85 ; P ¼ .03), and less radial shortening (1.4 mm vs 2.2 mm; P ¼ .01) in the VLP group. The QuickDASH score, which we selected as the primary clinical outcome measure, was insignificantly different between the groups (VLP 9 vs EF 11; P ¼ .…”

The operative treatment of fractures of the distal radius is increasing

“…5,9 The risk of complications after volar plating in terms of tendon rupture, hardware problems and nerve compression is reported to be approximately 10%, 10 and between 15% and 34% of patients have their hardware removed within a year. [11][12] Published studies that compare the clinical outcomes of volar plating and external fixation have shown that those treated with a volar plate return to normal function more quickly but the long-term outcome is equal after both treatments. 13,14 Recent studies from Austria 15,16 suggest that volar plating for fractures of the distal radius is no better than treatment in plaster for older patients.…”

External Fixator for Maintaining Reduction Before Volar Plating

“…Unfortunately, a high incidence rate of complex regional pain syndrome resulted from this "sandwich" method. 29 The presence of multiple small, comminuted fragments of the articular surface and comminuted cortical bone and compression of cancellous bone make surgery extremely difficult to perform. 23 It is passed along the radial diaphysis through the second or third compartment and laid on the second or third metacarpal extraarticular alignment, restoring radial inclination, volar tilt, and radial length.…”