Mondeep Gayan
BACKGROUND
External Fixation (EF) and Open Reduction and Internal Fixation (ORIF) have been the traditional surgical modalities for unstable distal radius fractures. The Locking Compression Plates (LCP) acting as “internal external fixators” are particularly valuable in difficult situations of fractures. We undertook a study to evaluate the outcome of unstable distal radius fractures treated with ORIF with LCP versus those treated by ligamentotaxis with external fixators.
MATERIALS AND METHODS
A comparative study was carried out in a tertiary care centre with 30 cases of unstable distal radius fractures (15 cases in each group). In one group, open reduction and internal fixation with distal radius volar locking compression plate was carried out and in the other group ligamentotaxis with external fixator was done. The patients were treated and followed up over a period of one and a half year between June 2011 to November 2012. The fractures were classified according to AO classification (Arbeitsgemeinschaft für Osteosynthesefragen: German for “Association for the Study of Internal Fixation” or AO). The functional results were evaluated at the end of 6 months according to Demerit point system of Gartland and Werley modified by Sarmiento (1975) and the anatomical results as per Lindstrom criteria (1959) modified by Sarmiento (1980).
RESULTS
Overall 86.66% (13) cases had good-to-excellent anatomical results in external fixator group as compared to 93.33% (14) cases in LCP group. The functional outcome was excellent in 80% (12) and good in 13.33% (2) cases in external fixator group as compared to 66.66% (10) excellent and 26.66% (4) good in LCP group.
CONCLUSION
Both open reduction and internal fixation with locking compression plate and ligamentotaxis with external fixators are good treatment modalities for unstable distal radius fractures. However, the choice should be guided by the fracture configuration, surgeons’ experience and patient’s profile.
