OBJECTIVES: Management of AO type B and C fractures of the distal radius is controversial. This study compares outcomes and complications of AO type B and C fractures of the distal radius treated with volar locked plating and nonoperative methods. MATERIALS AND METHODS: Sixty-four patients with fractures of the distal radius (AO type B and C) were included in this study, according to inclusion criteria, and were allocated to the volar plating group or nonoperative group by alternate randomization: 32 patients with odd numbers went into the nonoperative group and the other 32 with even numbers went into the volar plating group. Patients in the nonoperative group were managed with closed reduction of the fracture and plaster cast application under an image intensifier. Those in the volar plating group were managed by open reduction and fixation with a volar locked plate. Preoperative and postoperative serial clinico-radiological follow-up was done. The range of movement, grip strength, functional outcome scores and radiological parameters were compared. Student's t-test was used for statistical analysis with significance at p < 0.05. RESULTS:Range of movement and functional scores were significantly (p < 0.001) better in the volar plating group, but the difference in ulnar variance and radial and ulnar deviation was insignificant as compared to the nonoperative group. At 24 months follow-up, the nonoperative group had significantly more cases with malunion, articular incongruity and osteoarthritis. CONCLUSION: In cases of AO type B or C fractures of the distal radius, volar locked plating provides anatomical stable fixation and early mobilization with better clinico-radiological outcome as compared to conservative treatment.
RCT Entities:
OBJECTIVES: Management of AO type B and C fractures of the distal radius is controversial. This study compares outcomes and complications of AO type B and C fractures of the distal radius treated with volar locked plating and nonoperative methods. MATERIALS AND METHODS: Sixty-four patients with fractures of the distal radius (AO type B and C) were included in this study, according to inclusion criteria, and were allocated to the volar plating group or nonoperative group by alternate randomization: 32 patients with odd numbers went into the nonoperative group and the other 32 with even numbers went into the volar plating group. Patients in the nonoperative group were managed with closed reduction of the fracture and plaster cast application under an image intensifier. Those in the volar plating group were managed by open reduction and fixation with a volar locked plate. Preoperative and postoperative serial clinico-radiological follow-up was done. The range of movement, grip strength, functional outcome scores and radiological parameters were compared. Student's t-test was used for statistical analysis with significance at p < 0.05. RESULTS: Range of movement and functional scores were significantly (p < 0.001) better in the volar plating group, but the difference in ulnar variance and radial and ulnar deviation was insignificant as compared to the nonoperative group. At 24 months follow-up, the nonoperative group had significantly more cases with malunion, articular incongruity and osteoarthritis. CONCLUSION: In cases of AO type B or C fractures of the distal radius, volar locked plating provides anatomical stable fixation and early mobilization with better clinico-radiological outcome as compared to conservative treatment.
Authors: Andrew Lawson; Justine Naylor; Rachelle Buchbinder; Rebecca Ivers; Zsolt J Balogh; Paul Smith; Wei Xuan; Kirsten Howard; Arezoo Vafa; Diana Perriman; Rajat Mittal; Piers Yates; Bertram Rieger; Geoff Smith; Sam Adie; Ilia Elkinson; Woosung Kim; Jai Sungaran; Kim Latendresse; James Wong; Sameer Viswanathan; Keith Landale; Herwig Drobetz; Phong Tran; Richard Page; Sally Beattie; Jonathan Mulford; Ian Incoll; Michael Kale; Bernard Schick; Trent Li; Andrew Higgs; Andrew Oppy; Ian A Harris Journal: JAMA Surg Date: 2022-07-01 Impact factor: 16.681
Authors: C M Lameijer; H J Ten Duis; I van Dusseldorp; P U Dijkstra; C K van der Sluis Journal: Arch Orthop Trauma Surg Date: 2017-08-02 Impact factor: 3.067