Comparison of locked volar plating and percutaneous pinning without external fixation in the treatment of unstable extra-articular distal radius fractures: A single-blind randomized controlled trial

Abstract

Background: Distal radius fracture is one of the most common fractures with different treatment options. This study compared closed reduction and percutaneous pinning with cast immobilization to open reduction and locked volar plating in the treatment of adult patients aged 60 years or younger with isolated, unstable, closed extra-articular, distal radius fractures. Methods: In a single-blind controlled study, eighty eight patients were randomly divided into two groups; namely, the plating and pinning groups. Primary outcome was the severity of pain in the wrist joint which was measured via visual analog scale (VAS). The wrist range of movement, radiologic parameters, and ability in daily activities were also recorded as secondary outcomes and evaluated 3 and 12 months after the surgery. Findings: The severity of pain was significantly lower in plating group after 3 (P = 0.001) and 12 (P = 0.040) months. The range of movements was significantly better in the plating group after 3 (P = 0.001) and 12 (P = 0.001) months. No significant difference was observed in the ability to perform daily activities between the two groups 3 months after the treatment. Twelve months after the surgery, limitations in daily activities were significantly higher in the pinning group. 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 fractures. © 2017, Isfahan University of Medical Sciences(IUMS). All rights reserved.