George Allen John1, Dennis Antony2
BACKGROUND
Distal radius fractures are one of the most common injuries that orthopaedic
surgeons will face during their trauma practice. Despite this, many aspects in distal
radius fracture management like the definition of what constitutes an acceptable
reduction and when or even whether to operate a patient with a distal radius
fracture remain a poignant subject of debate even to this day. We wanted to
evaluate the functional outcome of fractures of distal end of radius managed with
buttress plate. The importance of anatomical reduction in attaining a good
functional outcome and post-operative complications of the procedure are also
studied.
METHODS
A prospective study of cases of distal end of radius fractures meeting the inclusion
criteria who were admitted in Thrissur Government Medical College, Kerala
between 1 – 01 - 2016 to 1 – 06 - 2017 was carried out. Fractures were classified
according to Frykman system and anatomical reduction of fragments attempted
using buttress plate and screws. After a minimum follow up period of 3 months,
the anatomical and functional outcomes were standardised using Lindstorms
anatomical and functional scoring system.
RESULTS
A series of 32 cases with distal end of radius fracture were studied comprising of
24 males and 8 females. Majority were in the age group of 20 to 29 years (50 %).
Road Traffic Accidents was the commonest cause of injury (62.5 %). Type III
Frykman made the largest contribution with 11 (34 %) cases. A total of 7 cases
were found to develop complications including blisters, joint stiffness, infection
and paraesthesia. Postoperatively, excellent anatomical reduction was achieved in
75 % of cases and good results in 12.5 % cases. Functionally 68.75 % cases had
an excellent outcome and 18.75 % had a good result.
CONCLUSIONS
Good to excellent results were seen in majority of patients after buttress plate
fixation of the distal radius, with outcomes and complications comparable to other
studies in literature. This study supports the finding that precise identification of
unstable lower radial fractures, and satisfactory anatomical restoration results in
improved functional outcome.
