J Korean Fract Soc.  2018 Jul;31(3):87-93. 10.12671/jkfs.2018.31.3.87.

A Comparison of the Results between Internal Fixation and External Fixation in AO C Type Distal Radius Fractures

• Lee YM
• Lee HS
• Song SW
• Choi JH
• Park JT

• KMID: 2417150
• DOI: http://doi.org/10.12671/jkfs.2018.31.3.87

Abstract

PURPOSE
The purpose of this study was to evaluate the radiological and clinical results of plate fixation and external fixation with additional devices for treating distal radius fracture in AO type C subtypes, and propose a treatment method according to the subtypes.
MATERIALS AND METHODS
Two hundred and one AO type C distal radius fracture patients were retrospectively reviewed. Eighty-five patients in group 1 were treated with volar or dorsal plate, and 116 patients in group 2, were treated with external fixation with additional fixation devices. Clinical (range of mtion, Green and O'Brien's score) and radiological outcomes were evaluated.
RESULTS
At the 12-month follow-up, group 1 showed flexion of 64.4°, extension of 68.3°, ulnar deviation of 30.6°, radial deviation of 20.8°, supination of 76.1°, and pronation of 79.4° in average; group 2 showed flexion of 60.5°, extension of 66.9°, ulnar deviation of 25.5°, radial deviation of 18.6°, supination of 73.5°, and pronation of 75.0° in average. The mean Green and O'Brien score was 92.2 in group 1 and 88.6 in group 2. The radial height of group 1 and group 2 was 11.6/11.4 mm; radial inclination was 23.2°/22.5°; volar tilt was 11.6°/8.7°; and the ulnar displacement was 1.27/0.93 mm.
CONCLUSION
Judicious surgical techniques during device application and tips for postoperative management during external fixation can produce similar clinical results compared with internal fixation patients.

Keyword

Distal radius; AO type C fracture; Plate fixation; External fixation; Functional outcome

MeSH Terms

Follow-Up Studies
Humans
Methods
Pronation
Radius Fractures*
Radius*
Retrospective Studies
Supination

Figure

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  Fig. 1. (A) Plain radiograph and computed tomography showing intraarticular fracture (AO type C2). (B) Internal fixation with volar locking plate by anterior approach. (C) Twelve months after operation, volar tilt was restored with good articular congruency.

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  Fig. 2. (A) Anteroposterior plain radiograph showing intraarticular distal radius fracture. (B) Sagittal view of computed tomography showing AO type C1 fracture. (C, D) Fracture was reduced and fixed by external fixation with intrafocal and interfragmentary pinnings for the fracture. (E) At the time of the most recent follow-up, there was good radiological results.

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  Fig. 3. (A, B) Anteroposterior and lateral radiographs of the wrist showed severe comminution of metaphysis and intraarticular extension of fracture line. (C) External fixator was applied for ligamentotatic effect and internal fixation was done with autogenous iliac bone graft for bone defect area. (D) At the time of 4 months postoperatively, solid union was obtained with a Green and O’Brien score of 93.

Reference

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