• Vol. 38 No. 7, 600–605
  • 15 July 2009

Prospective Randomised Study of Intra-Articular Fractures of the Distal Radius: Comparison Between External Fixation and Plate Fixation

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ABSTRACT

Introduction: Intra-articular fractures of the distal radius represent high energy, complex, unstable injuries and the optimal method of treatment remains controversial. Materials and Methods: The aim of the paper is to compare the outcomes of external fixation (EF) with open reduction internal fixation (ORIF) with plates and screw fixation in the treatment of intra-articular fractures of the distal radius. Thirty-fi ve patients were enlisted from December 2003 to September 2005 after a failure of initial conservative treatment. The patients were randomised into EF or ORIF groups. The patients were followed-up at 1 week, 3, 6, 12 and 24 months. Clinical and radiological outcomes were measured. They were scored using the Green and O’Brien or the Gartland and Wertley score. Results: Of the 35 patients, 5 defaulted the 6-month follow-up and were excluded. We found that the clinical and radiological outcomes for the 2 groups were not significantly different. Complication rates were also similar. Conclusion: There is no significant difference in the outcome of intra-articular distal radius fractures treated with either EF or ORIF.


Intra-articular fractures of the distal radius represent high energy, complex, unstable injuries and the optimal treatment remains controversial. Kreder et al1 showed that external fixation provides more rapid return to function and superior functional outcome within 2 years compared to open reduction and plate fixation, provided intra-articular step and gap deformity are minimised. Westphal, Piatek, Schubert, Winckler2 , on the other hand, showed no differences between external fixation and ORIF.

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