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Study finds volar plating may prove better than external fixation for distal radius fractures
Volar plating offered better functional outcomes with distal radius fractures than external fixation at 3 months and 6 months follow-up.
Patients with distal radius fractures treated with volar locking plates showed better functional recovery and radiographic outcomes than patients treated with external fixation, according to data from a prospective, randomized comparative study.
Volar plates and external fixation have both traditionally been used to treat distal radius fractures. Although patients in this study who were treated with volar plates had better outcome scores in some functional and radiologic categories at the 3-month and 6-month follow-up, the improvements did not last through the 12-month follow-up, according to Young Hak Roh, MD, PhD.
“There was no significant difference in functional score between the volar plating and external fixation grouping at final follow-up,” Roh said at the American Society for Surgery of the Hand Annual Meeting in Seattle.
Volar plating, external fixation compared
Roh and colleagues conducted a prospective, randomized study of an initial group of 92 patients with AO-type C2 and C3 distal radius fractures. Of that group, 74 patients were included in the final cohort. These patients were treated with either volar plating or external fixation, which consisted of K-wires.
Researchers compared the groups’ wrist range of motion, grip strength, Michigan Hand Questionnaire values, radial inclination, volar tilt, ulnar variance and articular congruity at baseline, 3 months, 6 months and 12 months after treatment.
Compared with patients who underwent external fixation, the volar plating group exhibited greater grip strength at 3 months and 6 months. Those patients also exhibited greater range of motion and higher Michigan Hand Questionnaire scores at 3 months, but not at 6 months, according to Roh.
Improvements lost at 1 year
One patient in the volar plating group and 3 patients in the external fixation group developed an intra-articular step-off deformity greater than 2 mm. The differences between the groups, in this case, did not reach statistical significance, Roh said.
Roh said there was no statistically significant difference in wrist range of motion, grip strength or Michigan Hand Questionnaire values between the groups at the final 1-year follow-up. A radiologic assessment showed better ulnar variance in the volar plating group than the external fixation group.
“The volar plating group showed superior radiologic outcomes in terms of the ulnar variance, but the radiologic outcomes did not influence functional outcomes at 12 months,” Roh said.
The researchers also found no statistically significant difference between the two groups with respect to volar tilt or radial inclination. – by Christian Ingram and Robert Linnehan
- Reference:
- Roh YH, et al. Paper #6. Presented at: American Society for Surgery of the Hand Annual Meeting; Sept. 10-12, 2015; Seattle.
- For more information:
- Young Hak Roh, MD, PhD, can be reached at Department of Orthopaedic Surgery, Gil Medical Center, Gachon University School of Medicine, 1198, Kuwol-dong, Namdong-gu, Incheon 405-760, Republic of Korea; email: ryhak@hanmail.net.
Disclosure: Roh reports no relevant financial disclosures.