Comparison of the Outcomes of Treatment on Comminuted Distal Radius Intraarticular Fracture by Volar Locking Plate Fixation and External Fixator

Introduction: Intra-articular fractures of the distal radius represent high-energy, complex, unstable injuries. An anatomical reduction of the joint surface with rigid ﬁxation is the main goal in the treatment of intra-articular distal radial fractures, but the optimal method of treatment remains controversial. The treatment strategies to achieve anatomical reduction for intra-articular fractures and possible surgical treatment methods are external fixation and open reduction and internal fixation (ORIF) by volar locking plate has become increasingly popular. This study aimed to analyze a comparison of the outcomes of treatment on comminuted distal radius intraarticular fracture by volar locking plate fixation and external fixator. Methods: This cross-sectional comparative study was conducted in the Department of Orthopedics, Sylhet M A G Osmani Medical College Hospital, Sylhet during the period from 1st July 2014 to 30th June 2016. A total of 24 cases of a distal radial comminuted intra-articular fracture. They were divided by random allocation into group-A and group B each comprising 12 patients. Every odd number of patients was taken as group-A and an even number of patients was taken as group B. The patients of group-A were treated with a volar locking plate and patients of group B were treated with an external fixator. Result: The age of the patients ranged from 21 to 50 years with a mean age of 33.7 (SD 9.4) years in group-A; while it was 25 to 60 years and 37.1 (SD 9.2) years respectively in group B. Outcome was measured using Quick DASH score and it was significantly lower in group-A than that of group-B [16.9 (SD 1.1) versus 21.5 (SD 4.5); t=-3.428; p<0.01). The outcome was also measured using O’Brien scoring system. The recorded Green O’Brien scoring score was significantly higher in group-A than that of group B [86.7 (SD 6.9) versus 77.9 (SD 10.3); t=2.446; p<0.05). There were 4 (33.3%) excellent, 7 (58.3%) good, and 1 (8.3%) fair in group-A; whereas ....