Journal
JOURNAL OF HAND SURGERY-AMERICAN VOLUME
Volume 42, Issue 3, Pages 156-165Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jhsa.2016.12.001
Keywords
Distal radius fracture; open reduction internal fixation; volar locking plate; fragment-specific fixation; randomized trial
Categories
Funding
- Swedish Research Council [2031]
- Greta and Johan Kock foundation
- Alfred Osterlund foundation
- Maggie Stephens foundation
- Thure Carlsson foundation
- Medical Faculty of Lund
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Purpose To compare the patient-reported, clinical, and radiographic outcome of 2 methods of internal fixation in distal radius fractures. Methods Fifty patients, mean age 56 years (range, 21-69 years) with primarily nonreducible or secondarily redisplaced distal radius fractures were randomized to open reduction internal fixation using volar locking plates (n = 25) or fragment-specific fixation (n = 25). The patients were assessed on grip strength, range of motion, patient-reported outcome (Quick Disabilities of the Arm, Shoulder, and Hand), pain (visual analog scale), health-related quality of life (Short Form-12 [SF-12]), and radiographic evaluation. Grip strength at 12 months was the primary outcome measure. Results At 12 months, no difference was found in grip strength, which was 90% of the uninjured side in the volar plate group and 87% in the fragment-specific fixation group. No differences were found in range of motion and the median Quick Disabilities of the Arm, Shoulder, and Hand score was 5 in both groups. The overall complication rate was significant, 21% in the volar locking plate group, compared with 52% in the fragment-specific group. Conclusions In treatment of. primarily nonreducible or secondarily redisplaced distal radius fractures, volar locking plates and fragment-specific fixation both achieve good and similar patient-reported outcomes, although more complications were recorded in the fragment-specific group. Copyright (C) 2017 by the American Society for Surgery of the Hand. All rights reserved.)
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