Open reduction internal fixation with plating versus external fixator in distal end radius fractures: A comparative study
Journal Title: National Journal of Clinical Orthopaedics - Year 2018, Vol 2, Issue 4
Abstract
Introduction: Low energy falls leading to stable variety of fracture patterns are seen most commonly, but young patients tend to have a high-energy mechanism of injury. Nonsurgical management remains main line of management; however, there are a variety of treatment options available for fractures too unstable for non-operative management. These include external fixation, percutaneous pinning, and internal fixation. The primary goal of treatment of these fractures is restoration of wrist function. Good functional outcome requires restoration of the disrupted radial anatomy, maintenance of accurate and stable reduction. There is no standard treatment algorithm for these fractures as most of the textbooks refer it as author’s experience. Various studies have shown excellent result with volar plating and early functional recovery. Assessment of the functional outcome between the volar platting and the external fixation with or without pinning in displaced distal radius fractures was the purpose our study. We hypothesized that there would be significantly fewer complications and improved clinical results in the volar plating group when compared to the external fixation group. Aim: To assess the functional outcome between the Volar platting and the external fixation with or without pinning in displaced distal radius fractures. Materials and Methods: This is an observational type of retrospective study where 40 patients were included in the study and among them 20 with external fixator/k wire and 20 with distal radius plating on whom the study conducted. Assessment of the fracture was based on AO classification. Adult Patients above age of 18 years with AO type B and C included in study. Patients with open/compound, pathological fractures excluded from study. Patients followed up at 6 weeks, 3 months, 6 months, 9 months and 12 months. At the 12 month follow-up final assessment was done for fracture union and patients were assessed for pain, wrist range of motion (ROM), grip strength and activity and scored according to the Modified Green O’Brien Scoring System. Results and Discussion: In present study, we got excellent functional results according to the G and O’Brein system in 11(55%) of patients treated with ORIF with plating group as compared to 4(20%) patients in the External fixation group. There was a significant difference in the mean value of the functional result in the Plating group (76.5) as compared to external fixator group (89.5).We evaluated our results and compared them with those obtained by various other studies utilising different modalities of treatment. Conclusion: Both ORIF plating and external fixation are good treatment choices for distal end radius fractures. ORIF PLATING provides better functional outcome as assessed by Green and O'Brien score as compared to external fixation.
Authors and Affiliations
Dr. Rameez Musa, Dr. Neel Bhavsar, Dr. Darshan Shah, Dr. Prarthan Amin, Dr. Jeet Gandhi, Dr. Shobhit Taneja
Keywords
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