1Department of Orthopaedics, T.N.M.C & B.Y.L Nair Hospital, Mumbai.
Address of correspondence: Dr Tarush Rustagi Department of Orthopaedics, T.N.M.C & B.Y.L Nair Hospital, Dr A.L.Nair Road, Mumbai Central, Mumbai 400008. Phone: 09920445617 Email: tarush.rustagi@gmail.com
Intraarticular distal end radius fractures are one of the common fractures. Both internal and external fixations are recommended for these fractures. This study investigates the functional outcome of these fractures, comparing the outcome between external and internal fixation.
97 patients with intraarticular distal end radius fracture were screened and 83 consented for the study. Patients with multiple injuries, extreme comorbid conditions, compound injuries and injuries with neurovascular deficiet were excluded (n=13). Total of 70 patients were randomised to recieve either external fixation (Group I) or open reduction and volar plating (Group II). Modified Green and O'Brien score was used to assess the outcome.
10 patients (6 group I, 4 group II) were lost to follow up. The two groups were comparable with respect to demographics and type of fracture according to modified AO classification. at the end of six months there were 10% excellent result (3/30), 23% were rated good(7/30), 46% as fair (14/30) and 20% poor (6/30) in the external fixator group. In the plating group there were 30% excellent result (9/30), 50% had good result (15/30), 16% rated fair (5/30) and 3% as poor (1/30). However at the end of one year there were 33% excellent result (10/30), 50% good (15/30), 10% were rated fair (3/30) and 6.6% as poor (2/30)in group I. In comparison in the plating group there were 43% excellent result (13/30), 53% good results (16/30), 3% were rated fair (1/30) and there were no poor results. There were 8 complication in group I, 4 Pin Track Infection, 2 adhesive capsulitis, 1 complex regional pain syndrome, 1 adhesive capsulitis and one loss of reduction. In group II there were 5 complication, 2 superficial infections, two complex regional pain syndrome and one tendon irritation due to long screws.
Although the results were better in the volar plate group at 6 months, there was no difference at one year and complications rates were also comparable. Thus both methods can be used for treatment of intraarticular fractures with good results and acceptable complication rates.
Intraarticular fractures, Volar locking plates, External fixator
