Bridging external fixation combined with Kirschner-wire fixation versus volar locked plate fixation for unstable fractures of the distal radius / 中国组织工程研究

ABSTRACT

BACKGROUND:The unstable distal radius fractures are clinical y treated with external fixation, open reduction and internal fixation at present. These two methods have their advantages and disadvantages. OBJECTIVE:To compare the radiological, clinical and functional outcomes of two groups of patients treated by bridging external fixation combined with Kirschner wire fixation versus volar locked plate for a displaced fracture of the distal radius. METHODS:We col ected 68 cases of unstable distal radius fractures in the Department of Reparative and Reconstructive Surgery, First Affiliated Hospital of Xinjiang Medical University, China from October 2014 to April 2016. They were randomly assigned to two groups, with 34 in each group. Patients in the external fixation group received external fixator and Kirschner wire. Patients in the internal fixation group received volar locked plate. In the fol ow-up, outcomes were assessed by radiographic parameters, function parameters, and Cooney functional score between both groups. RESULTS AND CONCLUSION:(1) Al patients were fol owed up. External fixation group was fol owed up for 12-16 months. Internal fixation group was fol owed up for 13-15 months. X-rays showed al fractures healed. (2) At 3 months postoperatively, significant differences in pronation, supination, extension and radial deviation were detected between the two groups (P0.05). The range of motion of the wrist was better in the internal fixation group, but no significant difference in the grip strength was determined between the two groups at any time points in 1-year fol ow-up. (3) These results demonstrated that compared with the external fixation, volar locked plate fixation showed better early recovery postoperatively. With time prolonged, clinical outcomes of both repair methods tended to be consistent.