To Compare the Functional Outcome of Intra Articular Distal end of Radius Fracture Treated by Conventional pop cast and External Fixatator Fixatation

Abstract

Introduction: Distal end of radius fractures frequently have a high degree of comminution, instability, and associated with soft tissue injuries. Treatment of this distal radius fracture is controversial and there is no single definitive treatment method that is considered the standard of care.

Objective: 1. To compare the functional results of the conventional POP cast and external fixator fixation of intra articular distal end of radius fracture. 2. To compare the radiological changes with that of functional outcome.

Methodology: It was a prospective study comparing the functional outcome of distal intra-articular radius fracture when managed by conventional POP cast and external fixatator fixation. The final outcome was decided on the basis of modified Gartland and Werley scoring system. Total 50 patients (19 – 54 years) were recruited. 30 were treated by closed reduction and POP cast and 20 by external fixation. Radiological parameters were graded according to Schecks criteria and fracture comminution was classified according to Frykman's classification.

Results: The functional outcome of the treatment was a subjective evaluation in which 80% of the patients had pain in external fixation as compared to 63% in closed reduction POP cast group. The restriction of activities was in 10% of the patient in external fixation group as compared with 33% in closed reduction POP cast group. The final scoring system as modification of Gartland and Werley point system had 5 ± 3 conventional pop cast group and 4 ± 4 in external fixation group. (p = 0.3764). On radiological evaluation, there was no significant difference in radial length, radial angle and volar tilt in two groups.

Conclsion: The results show no statistically significant difference between the two modes of interventions. External fixation provides easy mobilization of fingers and reduces edema and stiffness of joints. The active ranges of movements at the wrist joints were significantly better in external fixation group.