| Background:this study reports a retrospective review of the clinical data records of patients treated with external fixation (EF) and internal fixation (IF) for unstable AO/Type-A distal radius fractures (DRFs).Objectives:To compare the outcomes of internal fixation (IF) and external fixation with pin augmentation (EF) for unstable AO/type-A (extra-articular) DRFs; to outline the best treatment option for unstable AO/Type-A distal radius fracturesMethods:clinical data records of patients admitted with the diagnosis of distal radius fractures between February 1st 2014 and January 31st 2016 were reviewed. Patients were included if they met following criteria:1) Patients diagnosed as AO/Type-A DRFs; 2) patients treated with volar locking plates and bridging fixator with pin augmentation; 3) patients operated within the week after injury. All included patients were divided into two groups:group A (volar plates) and group B (bridging fixator with pin augmentation). Two groups were compared, and following endpoints were analyzed:demographic data, post-operative radiographic parameters and follow-up radiographic parameters and functional outcomes. The level of significance was set on 0.05.Results:Thirty patients were included for the study and divided into group A (n=20) and group B (n=10). Group A included 7 (35%) men and 13 (65%) women. The average age of the patients was 49±19.17 years (range,19 to 72 years). Average post-operative radial length, radial inclination, volar tilt and teardrop angles were 13.5±1.5 mm (range,11 to 16 mm),20.7±3° (range,16 to 26°),10.4±2.8°(range,5 to 15°), and 65.3±4.4°(range,55 to 72°), respectively. Average follow-up (6th month) quick DASH score was 10.1±3.3 (range, 6.8 to 18.2 mm) and wrist motion (ROM) consisted of 64.5±8.9°(range,45 to 80°) of flexion,69.4±5.7°(range,65 to 80°) of extension,66.2±6°(range,55 to 78°)of supination, 73.3±5.4°(range,60 to 78°) of supination,20.2±3.1° (range,15 to 25°) of radial deviation, and 33.4±3.9°(range,28 to 40°) of ulnar deviation.Group B included 3 (30%) men and 7 (70%) women. The average age of the patients was 63 ±8.4 years (range,52 to 79 years). Average post-operative radial length, radial inclination, volar tilt, and teardrop angles were 14.2±1.1 mm (range,12 to 16 mm),20.4±2.8°(range, 16 to 24°),6.2±3.9°(range,0 to 10°), and 59.4±6.4°(range,52 to 72°), respectively. Average follow-up (6th month) quick DASH score was 15.2±6.7 (range,9.1 to 29.5 mm) and range of wrist motion (ROM) consisted of 56.5±8.8°(range,45 to 75°)of flexion,58.5 ±10.8°(range,45 to 80°) of extension,58.5±4°(range,50 to 65°) of supination,59±8.4° (range,50 to 70°) of pronation,19.7±2.5°(range,16 to 22°) of radial deviation, and 27.2± 4°(range,20 to 30°) of ulnar deviation.There was significant difference (P<0.05) regarding post-operative radial length, volar tilt and teardrop angles measurements, follow-up quick DASH score and wrist ROM, including flexion, extension, pronation, supination and ulnar deviation.Conclusions:Internal fixation is superior to external fixation for unstable AO/Type-A distal radius fractures with regards to anatomic restoration of volar tilt and teardrop angle, and functional outcomes, including QD scores and wrist motions. However, there is no enough evidence to differentiate these two treatment methods with regard to complication rate. |
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