Functional Outcome of Volar Plating Versus Percutaneous Pinning with External Fixator for Unstable Distal Radius Fracture

Abstract

Introduction: Distal radius fractures are the most common fractures of the human skeleton. The percentage of these fractures that are unstable and require surgical fixation has been reported to be high. This study aimed to compare the functional outcome of two groups of patients treated either by bridging external fixators or volar locking plating for an unstable fracture of the distal radius.

Methods: This was an observational study done among 100 patients with unstable distal radius fractures. The study was conducted from 01 June 2018 to 30 December 2019 after obtaining ethical approval from the Institutional Review Board. Data were taken with respect to the treatment done either by volar plating or percutaneous pinning with an external fixator. The two groups were compared for clinical and functional outcomes. Radiographic measurements were also evaluated between the groups and complications were also noted. Data were entered and analysed in IBM SPSS Statistics version 27.0.

Results: The mean disabilities of the arm, shoulder and hand score of the volar plate group was 16.30±1.19 compared to 17.44±1.41 for the external fixation group with a p-value of 0.000 at a confidence interval of 95%. The mean value of time of clinical healing was 5.48±0.54 weeks in the volar plate group compared with 5.66±0.47 weeks in the external fixator group with a p-value of 0.082. Radiographically, ulnar variance, articular step-up, volar tilt, radial height, and radial inclination were statistically not significant in both groups.

Conclusions: The functional outcome of volar plating was better than external fixation regarding the disabilities of the arm, shoulder and hand score, but time of clinical healing and grip strength were similar in both groups. However, clinical outcome and radiographic parameters were statistically not significant in both groups.