Volar-locking plate versus external fixator in the management of distal radius fractures: An isokinetic study.

backgroundThe aim of this study was to compare the clinical and isokinetic evaluation of distal radius fractures treated by volar locking plate (VLP) and external fixator.

methodsThe study included fifty patients with distal radius fracture type C1/C2/C3. Twenty-seven patients (12 men, 15 women; mean age 49.5±4.42) underwent open reduction and VLP fixation, and 23 patients (10 men, 13 women; 52.1±4.6) underwent closed reduction and external fixation. The follow-up period was at least 12 months and the mean following time was 13.5±1.02 (12-15) months. The functional parameters measured were range of motion (ROM) and grip strength. Radiographic parameters (radial incli-nation, palmar tilt, and radial height) and isokinetic evaluation were measured at the 6 months and at the final follow-up after surgery. The isokinetic test was done at the speed of 60º/s. The non-fractured arm was tested first and all results were also expressed as a percentage of that on the normal side. Wrist scores according to the disability of the arm, shoulder, and hand (DASH) questionnaire were used.

resultsThe DASH scores, grip strength, and palmar flexion were better in VLP group at the 6 months (p<0.05). However, there were no differences between two groups at the one year (p=0.79). Isokinetic evaluation of the VLP showed that peak pronation torque and total pronation work were better than external fixation at the 6 month (p<0.05). At the final of follow-up was seen no significant differences between two groups (p=0.11).

conclusionWe looked at external fixation and locked volar plates in a prospective study and we found an improved range of movement and isokinetic evaluation outcome at 6 months after locked plating, but there were no differences between two groups at the final of follow-up. Our study showed no evidence for the superiority of one treatment over the other at the final follow-up.