Functional outcome in distal radius articular fractures treated by external fixator with k-wires versus volar-locking plating- A comparative study
Journal Title: Medpulse International Journal of Orthopedics - Year 2019, Vol 9, Issue 1
Abstract
Purpose: The purpose of this study was to compare the functional out come in distal radius articular fractures treated by closed reduction through bridging external fixator augmented with k-wires and volar-locking plating. Methods: This study included patients with comminute dunstable intra-articular distal radius fractures treated at Nalanda Medical College Hospital. 27 patients treated with either modality of treatment were analysed, who had been followed up for an averageofwas8.9 months, (range :3monthsto18 months).Prospective and retrospective data were gathered on patients, of which 15 were treated with external fixator augmented with k-wire and12weretreatedwith2-columnfixed angle volar LCP. The 2 groups were compared for range of motion(ROM), strength, and functional out come as measured by the Mayowrist score. Fracture reduction was evaluated from radiographs taken at the last follow-up visit and compared between groups. Sarmiento’s modification of Lindstorm’s criteria was used to compare the radiological out come in both the groups. Results: The mean passive wrist ROM at the final follow-up evaluation in extfixation patients was 55 degrees extension and 67 degrees flexion, compared with 69 degreesextensionand77degreesflexioninpatientstreatedwithvolar LCP group. Whereas mean passive wrist ROM at the final follow-up evaluation in extfixation patients was 58 degrees supination and 46 degrees pronation, compared with 76 degrees supination and 64 degrees pronation in patient streated with volar LCP group. Final radiographic measurements for the Extfixation group averaged 2.9 degrees volartilt and14.2 mm degrees radial inclination, with 5 mmradial length. The Volar LCP group averaged 7.3 degrees volartilt, 16.9 degrees radial inclination, with 9.75 mm radial length. Radial length and volartilt were significantly greater for the ORIF group when compared with the radial length. There was significant difference in the radiological and functional outcome of AOM uller type C fractures treated by volar LCP with respect to the externalfixator group (p value 0.009 and 0.026 respectively). There was no significant difference in the radiological and function a outcome of AOM uller type B fracture streated byv olar LCP with respect to the external fixator group(pvalue0.706and0.707 respectively).
Authors and Affiliations
Rishabh Kumar, Satendra Kumar Sinha, Anand Shankar, Satyendra Kumar
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