Dorsal bridge plating versus bridging external fixation for management of complex distal radius fractures

Introduction: Distal radius fractures are the most frequent upper limb injuries encountered by orthopedic surgeons. Surgical treatment of distal radius fractures is preserved for unstable and displaced fractures. A randomized controlled trial was conducted to compare the radiological and functional outcomes of bridge plating (BP) to external fixation (EF) in comminuted intra-articular distal radius fractures. Methods: Sixty patients with distal radius fractures were eligible for treatment by means of ligamento-taxis using either a dorsal bridge plate (30 patients) or an external fixator (30 patients) with or without supplementary Kirschner wires (K-wires). Radiological evaluation was done using the radial inclination angle, radial length, and the volar tilt. Clinical evaluation was performed using ranges of wrist motion, grip strength, Visual Analogue Scale (VAS), and a validated Arabic version of the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire Results: Patients were followed up for 12 months. No significant difference was found in terms of radio-graphic parameters or ranges of wrist motion. At 3-months follow-up, bridge plating group had stronger grip strength, lower Disability of the Arm, Shoulder, and Hand scores, and lower Visual Analogue Scale. However, both groups had similar functional outcomes at last follow-up. External fixation group had a higher rate of postoperative complications. Conclusion: In comparison to external fixation, bridge plating may provide earlier functional recovery with lower complication rates. However, no functional or radiological superiority were demonstrated at 12-months follow-up. (c) 2022 Elsevier Ltd. All rights reserved.

Automated summary

This study compared bridge plating and external fixation for the treatment of distal radius fractures. The results showed that bridge plating may lead to earlier functional recovery and lower complication rates compared to external fixation. However, no functional or radiological superiority was demonstrated at the 12-month follow-up.