R.G. Madhu1 , Manikumar C.J.2
BACKGROUND Distal radius fracture is the most common orthopaedic injury in adults. It has an approximate incidence of 1:10,000 people and 16 % are of skeletal and 74 % of forearm fractures. Many fractures of the distal radius are relatively uncomplicated and can be effectively managed with closed reduction and immobilization in a cast. Over the past twenty years, more sophisticated internal and external fixation techniques and devices for the treatment of distal radius fractures have been developed keeping up with the demands of the modern day. Functional outcome seems to follow the surgical treatment which results in more anatomical results. METHODS A total of thirty (n = 30) distal radial fractures were treated surgically by various methods at Government General Hospital, Kakinada. They were evaluated functionally with Quick Dash score at one and half, 3 and 6 months duration. Twenty cases were treated with a volar plate through Henry’s approach. Six cases were treated with per cutaneous k wire fixation and four cases were treated with forearm external fixator application (Ligamentotaxis). Final outcome was evaluated by QUICK DASH evaluation questionnaire. In each patient Quick Dash score were taken at 6 weeks, 3 months & 6 months interval along with range of motion at 6months interval up to 2 years. RESULTS There were 22 (73.3 %) males and 8 (26.6 %) females. The age group ranged between 15 - 80 years. Eleven (36.6 %) patients had right side involvement. Nineteen (63.3 %) had left side involvement. Of the 30 cases, mode of injury was fall on outstretched hand in 21 (70 %) patients and road traffic accident in 9 (30 %) patients. Functional outcome correlated positively with the degree of anatomical reduction. CONCLUSIONS Functional outcome correlated positively with the degree of radial length, volar tilt and radial inclination achieved when compared to normal side. The method of internal fixation with volar locking plate appears to be favoured by many akin to its ability to sustain the reduction. Comminuted intra articular fractures fared less well with more number of complications. However, fracture union time seems to be unaffected by the method of fixation.
