Abstract: Context: Distal end radius fractures are among the commonest fractures encountered in public health care. These injuries are associated with osteoporosis, articular damage, comminution and complex fracture pattern. These fractures should be managed according to fracture configuration and functional demand of patient.
Material and Methods: 110 patients with distal end radius fractures were managed with different surgical fixation. Out of them 58 were operated by locking plates, 44 were operated by percutaneous k wire pinning and external fixation was done in 8 patients. Mean age of study population was 46.4 year (range 20-75year) with slight male dominance. All patients were assessed post operatively by clinical and radiological methods in forms of DASH score, VAS pain score, range of motion at wrist joint, operative complication of each treatment modality, pinch and grip strength of both hands.
Results: Patients managed with plating had significantly better function, strength and range of motion as compared with patients operated with K-wiring or distractor in all 8 types of fractures (p<0.05). Mean DASH score, VAS pain score, range of motion and grip strengths were much better in locking plate group compared to k wire pinning and external fixation. Locking plate was also found better at restoring radiological parameters (radial tilt, radial inclination and radial height) as compared to other methods. Collapse in radial height was more in k-wiring group in patients with osteoporotic bones.
Conclusion: Improved understanding of fracture pattern and bone quality by various radiological examination demands proper fixation to get better functional outcomes. Locking plate has superior outcome for osteoporotic bone, articular damage and complex injuries while k wire pinning should be used for good quality bone with less functional demand and external fixation should be reserved for open injuries and poor skin texture.
