External Fixator and K-Wire Fixation Versus Locking Compression Plate in Management of Distal - End Radius Fractures Frykmann’s Type VII and VIII” -- A Randomised Controlled Trial

Abstract

BACKGROUND: Distal end radial fractures represent approximately one-sixth of all fractures treated in emergency department. External fixator is based on ligamentotaxis and is unable to prevent dorsal collapse of the radius or maintain the normal palmar tilt of the radiocarpal joint surface. This complication may predispose to posttraumatic wrist instability and arthritis. Locking compression plate ( LCP ) is a new screw – plate system developed by combining the traditional plating techniques with the principles of AO internal fixator. The distal radius is the foundation of the wrist joint , reconstruction of articular congruity and stable fixation reduces the incidence of posttraumatic osteoarthritis and allows early Functional rehabilitation. The goal of the current study is to assess the efficacy of anatomical and functional outcome in patients treated with external fixator and k-wire fixation or locking compression plate. MATERIALS AND METHODS: A prospective study, including 30 cases done in December 2008 to July 2010. The cases were followed up for 6months at intervals of 6 weeks, 3 months and 6 months. The results were evaluated by assessing their clinical and functional outcome at follow-up as per Demerit scoring system. All required routine investigations done pre-operatively. Study performed after obtaining consent of the patients. The Data analysis done for a period of 3 months using rates, ratios and Percentages of different outcomes as per Demerit scoring system , which will be computed and compiled. RESULTS : External fixator results : 2 patients achieved excellent , 8 patients had good, 3 fair results and 2 patients had poor results.LCP results: 3patients achieved excellent10 had good and 1achieved fair and 1 poor outcomes. No nonunion or infection occurred in present study. CONCLUSIONS: locking compression plating is a superior, safe and effective treatment for unstable fractures of the distal radius, giving excellent results in younger individuals and elderly osteoporotic patients.