Treatment of unstable extra-articular distal radius fractures using locked volar plating and percutaneous pinning without external fixation

Abstract

Introduction: One of the most common fractions is distal radius fracture, and various treatments have been suggested for this. The purpose of this study, is comparison of Open reduction and internal fixation by using a locked volar plating compared to percutaneous pinning by cast immobilization under the elbow in patients less than 60 years with good bone density that had unstable extra-articular distal radius fracture or UDRF. Methods: This study was clinical trial. 88 patients with closed UDRF who were referred for surgical treatment entered the study. Patients were randomized into two groups: group 1 had open reduction and internal fixation by using a locked volar plating and the other group had percutaneous pinning by cast immobilization surgeries. Amount of pain by using Visual analog scale or VAS and functional results of two methods were compared 3 and 12 month after surgeries. Findings: The intensity of pain was higher in the pinning group 3 and 12 month after treatment (P=0.001 and P=0.390 respectively). The range of motions in the plating group was significantly better (P<0.001). There was a significant difference in performing daily activities 3 month after treatment between the two groups, but a significant limitation in daily activities, observed 12 months after surgery in pinning group (P=0.004). Conclusion: Bone fixation, using locked volar plating, can be a better modality with regard to postsurgical pain and also the wrist range of motion than percutaneous pinning with cast immobilization in patients younger than 60 years sustaining unstable, closed extra-articular, distal radius fracture.