Fractures at the distal end of radius are one of the most frequent fractures1 encountered in the emergency department related to Orthopaedics. They have been treated since ages with closed manipulation and reduction, but maintaining reduction is a very difficult task, especially within a week after injury, after subsidence of swelling. Hence, in a majority of cases, casing gives a satisfactory reduction but can be lost, resulting in a poor anatomical and, in some cases, poor functional outcome. Displacement following conservative management with closed manipulation and casting, is an indicator of instability, and revision to correct the displacement by manipulation will not give a satisfactory alignment and thereafter resulting in poor functional outcome. Fractures at the distal end of the Radius, with displacement are considered unstable when alignment cannot be maintained after closed reduction in a plaster cast. For minimizing the loss of reduction in unstable distal radius fractures, various methods have been devised of which, Open reduction and internal fixation with plating provide better anatomical reduction and aids in early mobilization.
Aims and Objectives: To study the functional and radiological outcome in distal end of the Radius fractures managed with cast vs. plate.
Materials and Methods
Study Design: Hospital-Based Prospective study
Study period: November 2019 to October 2021
Study setup: Study will be conducted in Department of Orthopaedics, Andhra Medical College, Visakhapatnam.
Sample size: Number of patients, who sustained distal end of the radius fractures attending King George Hospital from November 2019 to October 2021 will be chosen.
Results: Both the treatment methods showed significant outcome at the time of post-intervention. While comparing the radiological parameters at 6thweek and 6thmonth, casting group have more significant changes in radiological parameters than the plating group which indicates that plating helps in maintaining reduction better than casting. Mean DASH scores were compared in two groups at the end of six weeks and six months. At end of six weeks p-value was 0.33 (˃0.05) and at end of six months p-value was 0.0048 (<0.05) indicating significant difference between two groups in terms of functional outcome at six months follow-up but not at six weeks follow-up.
Conclusion: Finally our study indicating that the plating is the best option for patients who are technically demanding and who wants an accelerated recovery of function while the casting is the best option for patients whose working capacities are sub-optimal and who is not in favour of any reoperation.