A comparative study of variable angle volar plate and bridging external fixator with K-wire augmentation in comminuted distal radius fractures
Purpose: Comminuted intraarticular distal radial fractures are difficult to treat conservatively and require operative treatment. This study compared the functional outcomes between variable angle volar plating and external fixator with K-wire augmentation in open reduction and internal fixation. Me...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-09-01
|
| Series: | Chinese Journal of Traumatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S100812752100078X |
| _version_ | 1819129639437598720 |
|---|---|
| author | Ratish Kumar Mishra Bhagwati Prasad Sharma Amit Kumar Rohit Sherawat |
| author_facet | Ratish Kumar Mishra Bhagwati Prasad Sharma Amit Kumar Rohit Sherawat |
| author_sort | Ratish Kumar Mishra |
| collection | DOAJ |
| description | Purpose: Comminuted intraarticular distal radial fractures are difficult to treat conservatively and require operative treatment. This study compared the functional outcomes between variable angle volar plating and external fixator with K-wire augmentation in open reduction and internal fixation. Methods: A total of 62 adult patients with comminuted intraarticular distal radius fracture were randomized into 2 groups: volar plate group and external fixator group. These patients aged between 18 and 60 years had unilateral fractures, and agreed to be included in the study. Patients with a history of fracture, bilateral fracture, associated other injuries, delayed injury for more than 2 weeks, open fracture, pre-existing arthrosis or disability, psychiatric illness and pathological fracture were excluded. Patients were followed up at 6 weeks, 3 months, 6 months and 1 year. The assessment of pain, functional activity, range of motion and grip strength was done at each stage of follow-up. The pain and functional activities were assessed by patient rated wrist evaluation (PRWE) score and disabilities of the arm, shoulder and hand (DASH) score. Results: Patients in volar plate group had superior PRWE score and DASH score at each stage of follow-up. At 1 year follow-up, the mean PRWE score were 7.48 for volar plate group and 7.35 for external fixator group; while the mean DASH score was 4.65 for volar plate group and 5.61 for external fixator group. They had better flexion and extension range of movement. They also had better pronation and supination range of motion at initial follow-up, however the difference get attenuated by 1 year. Volar plate group had significantly better grip strength than external fixator group. Complication rates were higher in external fixation group. Conclusion: Fixation with variable angle volar plate results in early wrist mobilization, better range of movement, less pain and disability and early return of function. |
| first_indexed | 2024-12-22T08:46:55Z |
| format | Article |
| id | doaj.art-f825399891a34dd0bb09c0c9a67ddf9e |
| institution | Directory Open Access Journal |
| issn | 1008-1275 |
| language | English |
| last_indexed | 2024-12-22T08:46:55Z |
| publishDate | 2021-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Chinese Journal of Traumatology |
| spelling | doaj.art-f825399891a34dd0bb09c0c9a67ddf9e2022-12-21T18:32:06ZengElsevierChinese Journal of Traumatology1008-12752021-09-01245301305A comparative study of variable angle volar plate and bridging external fixator with K-wire augmentation in comminuted distal radius fracturesRatish Kumar Mishra0Bhagwati Prasad Sharma1Amit Kumar2Rohit Sherawat3Orthopedic Department, Sir Gangaram Hospital, New Delhi 11006, IndiaCentral Institute of Orthopedics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, IndiaOrthopedic Department, All India Institute of Medical Sciences, Rae Bareli 229405, India; Corresponding author.Central Institute of Orthopaedics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, IndiaPurpose: Comminuted intraarticular distal radial fractures are difficult to treat conservatively and require operative treatment. This study compared the functional outcomes between variable angle volar plating and external fixator with K-wire augmentation in open reduction and internal fixation. Methods: A total of 62 adult patients with comminuted intraarticular distal radius fracture were randomized into 2 groups: volar plate group and external fixator group. These patients aged between 18 and 60 years had unilateral fractures, and agreed to be included in the study. Patients with a history of fracture, bilateral fracture, associated other injuries, delayed injury for more than 2 weeks, open fracture, pre-existing arthrosis or disability, psychiatric illness and pathological fracture were excluded. Patients were followed up at 6 weeks, 3 months, 6 months and 1 year. The assessment of pain, functional activity, range of motion and grip strength was done at each stage of follow-up. The pain and functional activities were assessed by patient rated wrist evaluation (PRWE) score and disabilities of the arm, shoulder and hand (DASH) score. Results: Patients in volar plate group had superior PRWE score and DASH score at each stage of follow-up. At 1 year follow-up, the mean PRWE score were 7.48 for volar plate group and 7.35 for external fixator group; while the mean DASH score was 4.65 for volar plate group and 5.61 for external fixator group. They had better flexion and extension range of movement. They also had better pronation and supination range of motion at initial follow-up, however the difference get attenuated by 1 year. Volar plate group had significantly better grip strength than external fixator group. Complication rates were higher in external fixation group. Conclusion: Fixation with variable angle volar plate results in early wrist mobilization, better range of movement, less pain and disability and early return of function.http://www.sciencedirect.com/science/article/pii/S100812752100078XComminutedDistal radius fractureIntraarticularVolar plateExternal fixator |
| spellingShingle | Ratish Kumar Mishra Bhagwati Prasad Sharma Amit Kumar Rohit Sherawat A comparative study of variable angle volar plate and bridging external fixator with K-wire augmentation in comminuted distal radius fractures Chinese Journal of Traumatology Comminuted Distal radius fracture Intraarticular Volar plate External fixator |
| title | A comparative study of variable angle volar plate and bridging external fixator with K-wire augmentation in comminuted distal radius fractures |
| title_full | A comparative study of variable angle volar plate and bridging external fixator with K-wire augmentation in comminuted distal radius fractures |
| title_fullStr | A comparative study of variable angle volar plate and bridging external fixator with K-wire augmentation in comminuted distal radius fractures |
| title_full_unstemmed | A comparative study of variable angle volar plate and bridging external fixator with K-wire augmentation in comminuted distal radius fractures |
| title_short | A comparative study of variable angle volar plate and bridging external fixator with K-wire augmentation in comminuted distal radius fractures |
| title_sort | comparative study of variable angle volar plate and bridging external fixator with k wire augmentation in comminuted distal radius fractures |
| topic | Comminuted Distal radius fracture Intraarticular Volar plate External fixator |
| url | http://www.sciencedirect.com/science/article/pii/S100812752100078X |
| work_keys_str_mv | AT ratishkumarmishra acomparativestudyofvariableanglevolarplateandbridgingexternalfixatorwithkwireaugmentationincomminuteddistalradiusfractures AT bhagwatiprasadsharma acomparativestudyofvariableanglevolarplateandbridgingexternalfixatorwithkwireaugmentationincomminuteddistalradiusfractures AT amitkumar acomparativestudyofvariableanglevolarplateandbridgingexternalfixatorwithkwireaugmentationincomminuteddistalradiusfractures AT rohitsherawat acomparativestudyofvariableanglevolarplateandbridgingexternalfixatorwithkwireaugmentationincomminuteddistalradiusfractures AT ratishkumarmishra comparativestudyofvariableanglevolarplateandbridgingexternalfixatorwithkwireaugmentationincomminuteddistalradiusfractures AT bhagwatiprasadsharma comparativestudyofvariableanglevolarplateandbridgingexternalfixatorwithkwireaugmentationincomminuteddistalradiusfractures AT amitkumar comparativestudyofvariableanglevolarplateandbridgingexternalfixatorwithkwireaugmentationincomminuteddistalradiusfractures AT rohitsherawat comparativestudyofvariableanglevolarplateandbridgingexternalfixatorwithkwireaugmentationincomminuteddistalradiusfractures |