Fragment-Specific Fixation Versus Volar Locking Plates in Primarily Nonreducible or Secondarily Redisplaced Distal Radius Fractures: A Randomized Controlled Study

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Abstract

Purpose: To compare the patient-reported, clinical, and radiographic outcome of 2 methods of internal fixation in distal radius fractures. Methods: Fifty patients, mean age 56 years (range, 21-69 years) with primarily nonreducible or secondarily redisplaced distal radius fractures were randomized to open reduction internal fixation using volar locking plates (n = 25) or fragment-specific fixation (n = 25). The patients were assessed on grip strength, range of motion, patient-reported outcome (Quick Disabilities of the Arm, Shoulder, and Hand), pain (visual analog scale), health-related quality of life (Short Form-12 [SF-12]), and radiographic evaluation. Grip strength at 12 months was the primary outcome measure. Results: At 12 months, no difference was found in grip strength, which was 90% of the uninjured side in the volar plate group and 87% in the fragment-specific fixation group. No differences were found in range of motion and the median Quick Disabilities of the Arm, Shoulder, and Hand score was 5 in both groups. The overall complication rate was significant, 21% in the volar locking plate group, compared with 52% in the fragment-specific group. Conclusions: In treatment of primarily nonreducible or secondarily redisplaced distal radius fractures, volar locking plates and fragment-specific fixation both achieve good and similar patient-reported outcomes, although more complications were recorded in the fragment-specific group. Type of study/level of evidence: Therapeutic II.

Original languageEnglish
Pages (from-to)156-165.e1
JournalThe Journal of Hand Surgery
Volume42
Issue number3
DOIs
Publication statusPublished - 2017

Subject classification (UKÄ)

  • Surgery
  • Orthopedics
  • Radiology, Nuclear Medicine and Medical Imaging

Keywords

  • Distal radius fracture
  • Fragment-specific fixation
  • Open reduction internal fixation
  • Randomized trial
  • Volar locking plate

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