A Comparative Study Protocol of External Fixation Versus Volar Plate in Treating Distal Radius Fracture

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2020 Dec 17

PMID 33327243

Citations 2

Authors

Fuqiang Zhang

Yang Yang

Hui Zhang

Xiangli Luo

Affiliations

Soon will be listed here.

Abstract

Background: The superiority of the open reduction and internal fixation (ORIF) and external fixation remains uncertain owing to the limited sample size involved in the literature. This retrospective cohort research was implemented for the comparison of the efficiency of ORIF and external fixation utilizing the locked volar plating in treating the intra-articular fractures of distal radius. We hypothesized that compared with the external fixation, ORIF can improve the functional scores and reduce complications.

Methods: We conducted a retrospective and single-center cohort trial that was approved by institutional review committee of Gansu Provincial Hospital. From June 2016 to July 2018, in our experiment, 178 patients with intra-articular fractures of the distal radius were recruited. Inclusion criteria in this cohort study were designed as follows: the age of patients is between 18 and 65 years, the patients with American Society of Anesthesiologists level I-III, and with the AO-type C3 or C2 fractures of distal radius confirmed by computed tomography scans, the patients with radiographic clinical follow-up for 1 year or >1 year. The patients participating in the trial would be divided into 2 groups: the patients treated via the external fixation and the patients treated by the ORIF utilizing volar plate. The main functional results were the grip strength and the range of motion of wrist. Radiographic measurement and complications were also evaluated in our study.

Results: This study protocol will guide and clarify our assignments, and the final outcomes and conclusion will further enrich the clinical knowledge in the literature.

Trial Registration: This study protocol was registered in Research Registry (researchregistry6116).

Citing Articles

Surgical options for distal radius fractures of type C in elderly patients over 65 years old: a comparison of external fixation with Kirschner wires and volar locking plate.

Zhang H, Liu M, Duan S, Liang H, Xu R, Cai Z J Orthop Surg Res. 2023; 18(1):669.

PMID: 37689739 PMC: 10493013. DOI: 10.1186/s13018-023-04162-0.

Efficacy of electroacupuncture in assisting postoperative healing of distal radius fractures: study protocol for a randomized controlled trial.

Fu J, Cai X, Ouyang H, Gong C, Huang Y J Orthop Surg Res. 2022; 17(1):517.

PMID: 36456969 PMC: 9713955. DOI: 10.1186/s13018-022-03415-8.

References

Saving J, Enocson A, Ponzer S, Navarro C . External Fixation Versus Volar Locking Plate for Unstable Dorsally Displaced Distal Radius Fractures-A 3-Year Follow-Up of a Randomized Controlled Study. J Hand Surg Am. 2018; 44(1):18-26. DOI: 10.1016/j.jhsa.2018.09.015. View

Roh Y, Lee B, Baek J, Noh J, Gong H, Baek G . A randomized comparison of volar plate and external fixation for intra-articular distal radius fractures. J Hand Surg Am. 2014; 40(1):34-41. DOI: 10.1016/j.jhsa.2014.09.025. View

Egol K, Walsh M, Tejwani N, McLaurin T, Wynn C, Paksima N . Bridging external fixation and supplementary Kirschner-wire fixation versus volar locked plating for unstable fractures of the distal radius: a randomised, prospective trial. J Bone Joint Surg Br. 2008; 90(9):1214-21. DOI: 10.1302/0301-620X.90B9.20521. View

Yu L, Zhang X, Zhang B, Hu C, Yu K, Tian D . Outcomes of volar locking plate (VLP) fixation for treatment of die-punch fracture of the distal radius: A retrospective single-surgeon study. Medicine (Baltimore). 2019; 98(33):e16796. PMC: 6831231. DOI: 10.1097/MD.0000000000016796. View

Li-hai Z, Ya-Nan W, Zhi M, Li-Cheng Z, Hong-da L, Huan Y . Volar locking plate versus external fixation for the treatment of unstable distal radial fractures: a meta-analysis of randomized controlled trials. J Surg Res. 2014; 193(1):324-33. DOI: 10.1016/j.jss.2014.06.018. View

Jeudy J, Steiger V, Boyer P, Cronier P, Bizot P, Massin P . Treatment of complex fractures of the distal radius: a prospective randomised comparison of external fixation 'versus' locked volar plating. Injury. 2011; 43(2):174-9. DOI: 10.1016/j.injury.2011.05.021. View

Gradl G, Gradl G, Wendt M, Mittlmeier T, Kundt G, Jupiter J . Non-bridging external fixation employing multiplanar K-wires versus volar locked plating for dorsally displaced fractures of the distal radius. Arch Orthop Trauma Surg. 2013; 133(5):595-602. DOI: 10.1007/s00402-013-1698-5. View

Porrino Jr J, Maloney E, Scherer K, Mulcahy H, Ha A, Allan C . Fracture of the distal radius: epidemiology and premanagement radiographic characterization. AJR Am J Roentgenol. 2014; 203(3):551-9. DOI: 10.2214/AJR.13.12140. View

Navarro C, Ahrengart L, Tornqvist H, Ponzer S . Volar Locking Plate or External Fixation With Optional Addition of K-Wires for Dorsally Displaced Distal Radius Fractures: A Randomized Controlled Study. J Orthop Trauma. 2015; 30(4):217-24. DOI: 10.1097/BOT.0000000000000519. View

10.

Xu G, Chan S, Puhaindran M, Chew W . Prospective randomised study of intra-articular fractures of the distal radius: comparison between external fixation and plate fixation. Ann Acad Med Singap. 2009; 38(7):600-6. View

11.

Luo P, Lou J, Yang S . Pain Management during Rehabilitation after Distal Radius Fracture Stabilized with Volar Locking Plate: A Prospective Cohort Study. Biomed Res Int. 2018; 2018:5786089. PMC: 6241235. DOI: 10.1155/2018/5786089. View

12.

Szekeres M, MacDermid J, Grewal R, Birmingham T . The short-term effects of hot packs vs therapeutic whirlpool on active wrist range of motion for patients with distal radius fracture: A randomized controlled trial. J Hand Ther. 2017; 31(3):276-281. DOI: 10.1016/j.jht.2017.08.003. View

13.

Tang J . Distal radius fracture: diagnosis, treatment, and controversies. Clin Plast Surg. 2014; 41(3):481-99. DOI: 10.1016/j.cps.2014.04.001. View

14.

Hevonkorpi T, Launonen A, Huttunen T, Kannus P, Niemi S, Mattila V . Incidence of distal radius fracture surgery in Finns aged 50 years or more between 1998 and 2016 - too many patients are yet operated on?. BMC Musculoskelet Disord. 2018; 19(1):70. PMC: 5834887. DOI: 10.1186/s12891-018-1983-0. View

15.

Windolf M, Schwieger K, Ockert B, Jupiter J, Gradl G . A novel non-bridging external fixator construct versus volar angular stable plating for the fixation of intra-articular fractures of the distal radius--a biomechanical study. Injury. 2009; 41(2):204-9. DOI: 10.1016/j.injury.2009.09.025. View

16.

Peng F, Liu Y, Wan Z . Percutaneous pinning versus volar locking plate internal fixation for unstable distal radius fractures: a meta-analysis. J Hand Surg Eur Vol. 2017; 43(2):158-167. DOI: 10.1177/1753193417735810. View

17.

Fu Q, Zhu L, Yang P, Chen A . Volar Locking Plate versus External Fixation for Distal Radius Fractures: A Meta-analysis of Randomized Controlled Trials. Indian J Orthop. 2018; 52(6):602-610. PMC: 6241055. DOI: 10.4103/ortho.IJOrtho_601_16. View

18.

Walenkamp M, Vos L, Strackee S, Goslings J, Schep N . The Unstable Distal Radius Fracture-How Do We Define It? A Systematic Review. J Wrist Surg. 2015; 4(4):307-16. PMC: 4626227. DOI: 10.1055/s-0035-1556860. View

19.

Saving J, Heintz E, Pettersson H, Enocson A, Navarro C . Volar locking plate versus external fixation for unstable dorsally displaced distal radius fractures-A 3-year cost-utility analysis. PLoS One. 2020; 15(10):e0240377. PMC: 7544026. DOI: 10.1371/journal.pone.0240377. View