Management of comminuted distal radial fractures using volar plating versus external fixation augmented by K wires

Abstract

Background: Distal radius fractures are the most common fractures of the upper extremity, representing approximately one-sixth of all fractures treated in the emergency room. Various classification systems are used to classify distal radius fractures. There are different methods for treatment of this type of fractures.
Objective: This study aimed to evaluate the best procedure in management of comminuted distal radial fractures and attainment of better outcomes.
Patient and methods: This study involved 30 patients with distal radial fractures who divided equally into: 15 patients performed volar plate in group (A) and other 15 patients applied external fixation augmented by K-wires group (B). The follow-up in was six months.
Results: The mean operation time was 54.00 ± 12.28 minutes in volar plating group, in comparison with 36.33 ± 5.16 minutes in external fixation group. There was statistically clinical significance between the two groups. Patients treated with volar plating had flexion range of 10-85, radial deviation range of 5-30 and ulnar deviation range of 20-40, while patients treated with external fixation augmented by k-wires had flexion range of 60-85, radial deviation range of 10-28 and ulnar deviation range of 20-35. Patients treated with external fixation augmented by k-wires had extension range of 45-85 better than those treated with volar plating (10-85). Patients treated with external fixation augmented by k-wires had grip strength range of 15-27, while patients treated with volar plating had grip strength range (8-27).
Conclusion: Volar plating had better functional outcomes when compared to external fixation. Whereas grip strength and ROM data were similar between the two groups.