Highlights
- •EF and BP have been proposed as better alternatives to volar plating in comminuted distal radial fractures.
- •EF is associated with pin-related complications, scarring of the extensor mechanism, and injury to the superficial sensory branch of the radial nerve.
- •The BP is kept entirely deep to the skin, thereby avoiding pin track complications, but the main disadvantage of BP is the need for a second surgery to remove the plate.
- •In comparison to external fixation, bridge plating may provide earlier functional recovery with lower complication rates.
- •No functional or radiological superiority of either device were demonstrated at 12-months follow-up.
Abstract
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
ligamentotaxis 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 radiographic 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.
Keywords
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Article info
Publication history
Published online: August 08, 2022
Accepted:
August 7,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
