Aim/Purpose
The aim of operative treatment of distal radius fractures is to achieve anatomic restoration and stable fixation allowing early wrist movement. The extraarticular radio-radial fixator may provide both.
In a prospective randomized trial, the nonbridging external fixator was compared with open reduction and internal fixation by volar fixed angle plating.
Methods
A total of 62 patients with extraarticular fractures of the distal radius were included in a prospective randomized trial: 33 patients were treated by external fixation and 29 patients by internal plate fixation. Follow-up examinations were carried out 8 weeks, 6 months, and 1 year after surgery.
Results
The time for surgery using the nonbridging external fixator was significantly less (41 minutes) than using volar plating (56 minutes), whereas intraoperative fluoroscopy time turned out to be twice as long (2 minutes). The functional outcome was good or excellent in both treatment groups. Eight weeks after surgery, patients with nonbridging external fixation presented with significantly less grip strength (26% of the contralateral hand) compared to patients with volar plating (48% of the contralateral hand). The restoration of the physiological volar tilt was achieved more precisely by external fixation. The results of the SF-36 health survey did not show any significant differences between both groups.
Conclusion
Nonbridging external fixation is a good alternative treatment option to open reduction and volar plating. The minimally invasive technique allows for anatomical restoration and safe reduction permitting early range of motion. The clinical and radiological results are good to excellent accompanied by a low rate of complications.