Functional Outcomes in the Distal End of Radius Fracture: A Prospective Study in a Tertiary Care Center.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

Conflict of interest statement: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Ethical Committee, Jammu issued approval IEC/GMC/2022/8/8. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. 13. Cureus. 2020 Aug 19;12(8):e9875. doi: 10.7759/cureus.9875. Management of Distal Radius Fractures: Comparison of Three Methods. Ermutlu C(1), Mert M(2), Kovalak E(3), Kanay E(4), Obut A(5), Öztürkmen Y(6). Author information: (1)Orthopaedics, Bursa Uludag University School of Medicine, Bursa, TUR. (2)Orthopaedics and Traumatology, Yeni Yüzyıl Üniversitesi, İstanbul, TUR. (3)Orthopaedics and Traumatology, Biruni University Medical School, Istanbul, TUR. (4)Orthopaedics and Traumatology, Istanbul Beykoz State Hospital, Istanbul, TUR. (5)Orthopaedics and Traumatology, Bursa State Hospital, Bursa, TUR. (6)Orthopaedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, TUR. Introduction Distal radius fractures are the most common type of all extremity fractures. It is generally accepted that fractures with more than 2 mm step-off in the radiocarpal joint and greater than 10 degrees dorsal tilt should be treated surgically. However, the ideal technique for surgical management is still a point of debate. We performed cross-sectional data analysis to compare the results of three treatments methods - volar locking plate (VLP), external fixation (EF), Kirschner wire (K-wire) - in patients with distal radius fractures, and compared the clinical, functional, and radiological results Materials and methods Forty-four patients with distal radius fractures who underwent fixation with VLP, K-wire or EF between 2011 and 2013 were included in the study. All fractures were classified according to the Müller's Arbeitsgemeinschaft für Osteosynthesefragen (AO) and Frykman's classifications. Routine radiographs were taken at the postoperative three weeks, six weeks, and three months. Radial inclination, volar tilt, radial length and ulnar variance were assessed on the follow-up visits and additionally at the follow -up for the study. The patient-based Disabilities of the Arm, Shoulder and Hand (DASH) score system and the physician-based MAYO scale were used to evaluate functional outcomes. Radiological and functional outcomes between three surgical modalities were compared and statistically analyzed. Results The average age at the time of surgery was 52 years (range = 35-69 years). Of a total of 44 patients, 28 were operated with VLP, 11 were with K-wire and five with EF. Satisfactory reduction was achieved in all fractures, and all of the fractures healed. DASH and MAYO scores were similar in all groups. Regarding radiographic parameters, there was no significant difference in radial inclination, volar tilt, radial length and ulnar variance between the treatment modality groups. When evaluated based on fracture geometry, the DASH score was significantly higher in the patients with AO23A type fracture compared to the patients with AO23B and AO23C type fractures. As for MAYO score, all AO23 groups had similar outcomes. Conclusions Surgical treatment options VLP, EF, and K-wire provide adequate fixation, satisfactory radiological, and functional results for the management of distal radius fractures of various severities. The optimal treatment approach depends on individual features, and the choice for an internal fixation or closed reduction method for the restoration of wrist function should be evaluated thoroughly by the operating surgeon considering the patient-related variations. Copyright © 2020, Ermutlu et al. DOI: 10.7759/cureus.9875 PMCID: PMC7500733