Published online Oct 18, 2016. doi: 10.5312/wjo.v7.i10.687
Peer-review started: May 27, 2016
First decision: July 6, 2016
Revised: July 27, 2016
Accepted: August 6, 2016
Article in press: August 8, 2016
Published online: October 18, 2016
Processing time: 138 Days and 22.5 Hours
To compare the outcomes of displaced distal radius fractures treated with volar locking plates and with immediate postoperative mobilisation with the outcomes of these fractures treated with modalities that necessitate 6 wk wrist immobilisation.
A prospective, randomised controlled single-centre trial was conducted with 56 patients who had a displaced radius fracture were randomised to treatment either with a volar locking plate (n = 29), or another treatment modality (n = 27; cast immobilisation with or without wires or external fixator). Outcomes were measured at 12 wk. Functional outcome scores measured were the Patient-Rated Wrist Evaluation (PRWE) Score; Disabilities of the Arm, Shoulder and Hand and activities of daily living (ADLs). Clinical outcomes were wrist range of motion and grip strength. Radiographic parameters were volar inclination and ulnar variance.
Patients in the volar locking plate group had significantly better PRWE scores, ADL scores, grip strength and range of extension at three months compared with the control group. All radiological parameters were significantly better in the volar locking plate group at 3 mo.
The present study suggests that volar locking plates produced significantly better functional and clinical outcomes at 3 mo compared with other treatment modalities. Anatomical reduction was significantly more likely to be preserved in the plating group. Level of evidence: II.
Core tip: The present study suggests that the treatment of distal radius fractures with volar locking distal radius plates and immediate postoperative mobilisation produces better functional, radiological and clinical outcomes at three months compared with other treatment modalities which necessitate six weeks immobilisation post fracture. Short term outcomes are very important in our view, as early mobility potentially means earlier return to activities of daily life and return to work for younger patients and remaining functionally independent for the elderly. Future studies should focus on cost savings gained by earlier return to activities of daily living.