Abstract: Fractures of the distal end of radius are the most common fractures of the upper extremity and account for approximately 1/6th (17%) of all fractures seen and treated in emergency rooms, external fixation devices are an excellent means of overcoming the displacing forces of the forearm muscles (by ligamentotaxis), devices like volar locking plates allow improved fracture fixation. They have been shown to provide excellent stability for an unstable fracture.
The purpose of this study is to compare the two modalities for treatment of Intra-articular fracture of distal radius.
Methods: This prospective study will be conducted in participants admitted in Sri Siddhartha medical college hospital, Tumkur between September-2020 to September-2022 with intra-articular fracture of distal end of radius. Follow up at 6th week, 12th week and 16th week.
Results: In present study, the mean Quick DASH scores in external fixator group was 10.4±4.7 compaired to volar plating group 7.1±2.9 at the final (16 week) follow up. At final visit, VLP performed better in wrist palmar flexion (VLP: 65.7±5.3° vs EF: 72.7±5.4°, p < 0.001), dorsiflexion (VLP: 62.0±3.3o vs EF: 71.6±5.8o, p <0.001), forearm pronation (VLP: 66.2±5.6° vs EF: 74.2±5.7°, p < 0.001), supination (VLP: 66.7±4.9° vs EF: 77.4±6.8°, p < 0.001), ulnar deviation (VLP: 19.6±1.8o vs EF: 21.1±1.6o, p = 0.001) and radial deviation (VLP: 17.6±1.8o vs EF: 18.9±1.6o, p = 0.003) than Ex fix group. Complication rate were higher in close reduction and external fixation group (30.3%) as compared to open reduction and volar plating group (21.2%).
Conclusion: Internal fixation with volar locking plate yield better functional outcome in unstable distal radius fracture in a short term follow up of 16 weeks, Range of movement was better in participants treated with volar locking plate.
