EFFECTIVENESS COMPARISON OF EXTERNAL FIXATION AND VOLAR LOCKING COMPRESSION PLATE IN TREATMENT OF DISTAL RADIUS FRACTURES OF TYPE C_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 SHALiangkuan , CHENQingyu , SUNLingtong , DONGBin , LILixi

Department of Orthopedic Joint, the Central Hospital of Zaozhuang Mining Group of Shandong, Zaozhuang Shandong, 277800, P. R. China;

Corresponding author：

SHALiangkuan, Email: 1623935191@qq.com

Keywords：

Distal radius fracture; External fixator; Locking compression plate

DOI：

10.7507/1002-1892.20150148

Video：

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Objective To compare the effectiveness of external fixation and volar locking compression plate in the treatment of distal radius fractures of type C. Methods Between March 2012 and March 2013, 122 patients with distal radius fractures of type C were enrolled in the prospective randomized study. Fractures were treated by external fixation in 61 patients (external fixation group) and by open reduction and internal fixation using a volar locking compression plate in 61 patients (plate group). There was no significant difference in age, gender, fracture side, weight, height, body mass index, fracture type, and interval of injury and operation between 2 groups (P>0.05). The blood loss, operation time, hospitalization days, fracture union time, wrist function, and complications were compared between 2 groups. And the quality of reduction was observed, including volar tilting angle, ulnar deviation, radial height, and articular reduction. Results The blood loss, operation time, and hospitalization days in plate group were significantly higher than those in external fixation group (P<0.05). All of the patients in both groups were followed up 12-28 months. Postoperative complications occurred in 4 patients (6.6%) of external fixation group (pin tract infection in 2 cases and radial nerve neuritis in 2 cases) and in 5 patients (8.2%) of plate group (wound infection in 1 case, carpal tunnel syndrome in 2 cases, and tendon rupture in 2 cases), showing no significant difference between 2 groups (P=0.500). The X-ray films showed fracture healing in all patients of 2 groups; the union time of plate group was significantly longer than that of external fixation group (P<0.05). At last follow-up, there was no significant difference in ulnar deviation and radial height between 2 groups (P>0.05), but the volar tilting angle of plate group was significantly larger than that of external fixation group (P<0.05). There was no significant difference in wrist function and articular reduction between 2 groups (P>0.05). Conclusion For distal radius fractures of type C, the use of external fixation or volar locking compression plate can obtain satisfactory clinical outcomes, but the external fixation has the advantages of less invasion, shorter hospitalization days, minor complications, and faster fracture union.

Citation： SHALiangkuan, CHENQingyu, SUNLingtong, DONGBin, LILixi. EFFECTIVENESS COMPARISON OF EXTERNAL FIXATION AND VOLAR LOCKING COMPRESSION PLATE IN TREATMENT OF DISTAL RADIUS FRACTURES OF TYPE C. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(6): 683-687. doi: 10.7507/1002-1892.20150148 Copy

1.	金粉勤, 薛锋, 徐雪荣. 外固定支架与钢板内固定治疗桡骨远端不稳定型骨折的疗效比较. 中华创伤骨科杂志, 2013, 15 (1):87-89.
2.	Porrino JA Jr, Maloney E, Scherer K, et al. Fracture of the distal radius:epidemiology and premanagement radiographic characterization. AJR Am J Roentgenol, 2014, 203 (3):551-559.
3.	Kumbaraci M, Kucuk L, Karapinar L, et al. Retrospective comparison of external fixation versus volar locking plate in the treatment of unstable intra-articular distal radius fractures. Eur J Orthop Surg Traumatol, 2014, 24 (2):173-178.
4.	Moradi A, Ebrahimzadeh MH, Jupiter JB. Intra-articular fractures of the distal radius:bridging external fixation in slight flexion and ulnar deviation along articular surface instead of radial shaft. Tech Hand Up Extrem Surg, 2014, 18 (1):41-50.
5.	Paksima N, Panchal A, Posner MA, et al. A meta-analysis of the literature on distal radius fractures:review of 615 articles. Bull Hosp Joint Dis, 2004, 62 (1-2):40-46.
6.	Bass RL, Blair WF, Hubbard PP. Results of combined internal and external fixation for the treatment of severe AO-C3 fractures of the distal radius. J Hand Surg (Am), 1995, 20 (3):373-381.
7.	Huch K, Hunerbein M, Meeder PJ. External fixation of intra-articular fracture of the distal radius in young and old adults. Arch Orthop Trauma Surg, 1996, 115 (1):38-42.
8.	Kawaguchi S, Sawada K, Nabeta Y, et al. Recurrent dorsal angulation of the distal radius fracture during dynamic external fixation. J Hand Surg (Am), 1998, 23 (5):920-925.
9.	Cronier P, Talha A, Toulemonde JL, et al. Results of distraction by way of external metacarporadial fixation in fracture of the distal end of the radius. Apropos of 97 cases. J Chir (Paris), 1991, 128 (1):8-12.
10.	Kandemir U, Matityahu A, Desai R, et al. Does a volar locking plate provide equivalent stability as a dorsal nonlocking plate in a dorsally comminuted distal radius fracture?:a biomechanical study. J Orthop Trauma, 2008, 22 (9):605-610.
11.	姜宗圆, 马涛, 夏江, 等. 蝶形锁定钢板在复杂桡骨远端骨折中的应用. 中国修复重建外科杂志, 2014, 28 (6):665-668.
12.	Laulan J, Bismuth JP, Clément P, et al. An analytical classification of fractures of the distal radius:The "M.E.U." classification. Chir Main, 2007, 26 (6):293-299.
13.	Cooney WP, Bussey R, Dobyns JH, et al. Difficult wrist fractures. Clin Orthop Relat Res, 1987, (214):136-147.
14.	Knirk JL, Jupiter JB. Intra-articular fractures of the distal end of the radius in young adults. J Bone Joint Surg (Am), 1986, 68(5):647-659.
15.	Koo KO, Tan DM, Chong AK. Distal radius fractures:an epidemiological review. Orthop Surg, 2013, 5 (3):209-213.
16.	殷兵, 刘磊, 陈伟, 等. 2003年至2012年河北医科大学第三医院成人尺桡骨远端骨折的流行病学研究. 中华创伤骨科杂志, 2014, 16 (4):316-319.

1. 金粉勤, 薛锋, 徐雪荣. 外固定支架与钢板内固定治疗桡骨远端不稳定型骨折的疗效比较. 中华创伤骨科杂志, 2013, 15 (1):87-89.
2. Porrino JA Jr, Maloney E, Scherer K, et al. Fracture of the distal radius:epidemiology and premanagement radiographic characterization. AJR Am J Roentgenol, 2014, 203 (3):551-559.
3. Kumbaraci M, Kucuk L, Karapinar L, et al. Retrospective comparison of external fixation versus volar locking plate in the treatment of unstable intra-articular distal radius fractures. Eur J Orthop Surg Traumatol, 2014, 24 (2):173-178.
4. Moradi A, Ebrahimzadeh MH, Jupiter JB. Intra-articular fractures of the distal radius:bridging external fixation in slight flexion and ulnar deviation along articular surface instead of radial shaft. Tech Hand Up Extrem Surg, 2014, 18 (1):41-50.
5. Paksima N, Panchal A, Posner MA, et al. A meta-analysis of the literature on distal radius fractures:review of 615 articles. Bull Hosp Joint Dis, 2004, 62 (1-2):40-46.
6. Bass RL, Blair WF, Hubbard PP. Results of combined internal and external fixation for the treatment of severe AO-C3 fractures of the distal radius. J Hand Surg (Am), 1995, 20 (3):373-381.
7. Huch K, Hunerbein M, Meeder PJ. External fixation of intra-articular fracture of the distal radius in young and old adults. Arch Orthop Trauma Surg, 1996, 115 (1):38-42.
8. Kawaguchi S, Sawada K, Nabeta Y, et al. Recurrent dorsal angulation of the distal radius fracture during dynamic external fixation. J Hand Surg (Am), 1998, 23 (5):920-925.
9. Cronier P, Talha A, Toulemonde JL, et al. Results of distraction by way of external metacarporadial fixation in fracture of the distal end of the radius. Apropos of 97 cases. J Chir (Paris), 1991, 128 (1):8-12.
10. Kandemir U, Matityahu A, Desai R, et al. Does a volar locking plate provide equivalent stability as a dorsal nonlocking plate in a dorsally comminuted distal radius fracture?:a biomechanical study. J Orthop Trauma, 2008, 22 (9):605-610.
11. 姜宗圆, 马涛, 夏江, 等. 蝶形锁定钢板在复杂桡骨远端骨折中的应用. 中国修复重建外科杂志, 2014, 28 (6):665-668.
12. Laulan J, Bismuth JP, Clément P, et al. An analytical classification of fractures of the distal radius:The "M.E.U." classification. Chir Main, 2007, 26 (6):293-299.
13. Cooney WP, Bussey R, Dobyns JH, et al. Difficult wrist fractures. Clin Orthop Relat Res, 1987, (214):136-147.
14. Knirk JL, Jupiter JB. Intra-articular fractures of the distal end of the radius in young adults. J Bone Joint Surg (Am), 1986, 68(5):647-659.
15. Koo KO, Tan DM, Chong AK. Distal radius fractures:an epidemiological review. Orthop Surg, 2013, 5 (3):209-213.
16. 殷兵, 刘磊, 陈伟, 等. 2003年至2012年河北医科大学第三医院成人尺桡骨远端骨折的流行病学研究. 中华创伤骨科杂志, 2014, 16 (4):316-319.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS COMPARISON OF EXTERNAL FIXATION AND VOLAR LOCKING COMPRESSION PLATE IN TREATMENT OF DISTAL RADIUS FRACTURES OF TYPE C

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