Abstract
Purpose
To elucidate whether there is an advantage in external fixation supplementation of K-wires in comparison to K-wires and plaster, in the treatment of distal radius fractures without metaphyseal comminution.
Indications
Distal intraarticular radius fractures, Frykman VIII or VIII without metaphyseal comminution.
Contraindications
Metaphyseal comminution, general medical contraindications for surgical intervention.
Study design
Fifty-one patients were prospectively randomised in two groups: 24 patients were treated with K-wire and spanning external fixation supplementation, and 27 were treated with K-wires and plaster.
Results
Patients were monitored following the operation with a minimum follow up of 1 year, and checked independently of surgeon for pain, satisfaction and range of motion. There was a statistically significant difference in favour of the external fixation patient group for pain (Visual Analogue Score, Ex-Fix group: mean 14.9, plaster group: mean 28.1, p<0.001) and satisfaction (Ex-Fix group: mean 89.7, plaster group: mean 76.3, p<0.001,). Although one would expect that range of motion would be reduced in the external fixation group, there were no statistically significant differences found in favour of plaster; on the contrary supination results were surprisingly in favour of the external fixation group (Ex-Fix group: mean 54.4, plaster group: mean 45.2, p<0.05).
Conclusion
In this study, external fixation supplementation of K-wiring had statistically significant superior results in patient satisfaction score, pain score, and wrist supination in comparison to plaster augmentation of K-wiring.
