Dorsally displaced distal radius fractures fixation: Dorsal versus volar plating. A randomized controlled study
Journal Title: International Journal of Orthopaedics Sciences - Year 2018, Vol 4, Issue 3
Abstract
Background: Distal radius fractures are one of the most common fractures of human skeleton accounting for one sixth of all fractures seen in emergency room. Close reduction and cast immobilization used to be the mainstay of treatment of the fractures of the distal radius. Best modality of achieving restoration of anatomy of wrist is by open reduction and internal fixation with plating. Significant controversies exist about whether dorsal or volar plating is superior for fixation of dorsally comminuted distal radial fractures. The aim of this study is to compare outcome of dorsally displaced fracture of distal end radius managed with Dorsal plating vs volar plating. Materials and methods: The study was conducted in Department of Orthopaedics, RIMS, and Ranchi from October 2016 to October 2017 (one year duration). Thirty skeletally mature patients of either sex (18 male and 12 female), presenting with dorsally displaced distal radius fracture, (AO type A and C) were selected for the study. The mean age of the patients was around 50 yrs. We conducted a prospective randomized study between a group of 16 patients treated with a dorsal plating (group 1) and a group of 14 patients managed with volar plating (group II). We analyzed both the clinical results (complications and functional evaluation) and the radiographic results from A/P and lateral radiographs in the early postoperative period and at 6 weeks, 3 months, 6 months follow up. Results: Volar plating had better range of wrist movement in all directions with significant difference in dorsiflexion, pronation and supination movement. As per Gartland and werley score, functional outcome in both groups increased post operatively with continued physiotherapy and rehabilitation. The differences were non-significant. Radiological determinants were volar angle, radial length and radial inclination. Results shows, marginal better maintenance of radiological parameters with dorsal plating then volar plating but the differences between two groups are statistically non- significant, {p>0.05}. Complications between two groups have no significant difference Incidence of neurological complication was more seen with volar plating, while dorsal plating associated with tendon irritation and hardware problems Conclusion: Both Dorsal plating and Volar plating are valid approach to fix dorsally displaced fracture distal end radius. As functional outcome in patients managed with volar plating is better than those managed with dorsal plating so, volar plating should be the approach of choice.
Authors and Affiliations
Dr. Ankur Ojha, Dr. Ravijeet Prakash, Dr. Shashi Kant Kumar Singh, Dr. LB Manjhi
Keywords
Related Articles
- EP ID EP487661
- DOI 10.22271/ortho.2018.v4.i3i.84
- Views 115
- Downloads 0
Treatment of forearm fractures in children and adolescents with titanium elastic nails (Tens): A prospective study
Paediatric forearm fractures are generally treated nonoperatively by close reduction and casting. Recently there has been trend on intramedullary nailing of diaphyseal forearm fractures for unstable fracture pattern to i...
A new geometrical method (BMCRI Method) for measuring cup anteversion after total hip replacement
Back ground: In total hip replacement the cup placement is critical. Orientation is determined by anteversion and abduction. We have devised a simple geometrical method to calculate anteversion using simple instruments w...
Evaluation of functional outcome of tension band wiring in olecranon fractures and factors affecting the overall functional outcome
Aim: The aim of this study is to evaluate the functional outcomes of olecranon fractures treated with tension band wiring and factors affecting it. Materials and methods: this study consisted of 30 patients with olecrano...
Arthroscopic management of post traumatic anterolateral soft tissue ankle impingement
Purpose: Was to evaluate the results of arthroscopic management of anterolateral soft tissue anke impingement (ALSTAI) secondary to ankle inversion injuries. Patients and Methods: We treated 27 cases of ALSTAI by arthros...
Titanium elastic nailing in shaft femur fracture in paediatric patients
Background: Paediatric shaft femoral fracture can be treated either conservatively or by internal fixation. Complications inherited with cast management and advantages of the intramedullary nailing in long bone fracture,...