Volar-locking plate versus external fixator in the management of distal radius fractures: An isokinetic study

BACKGROUND: The aim of this study was to compare the clinical and isokinetic evaluation of distal radius fractures treated by volar locking plate (VLP) and external fixator. METHODS: The study included fifty patients with distal radius fracture type C1/C2/C3. Twenty-seven patients (12 men, 15 women; mean age 49.5 +/- 4.42) underwent open reduction and VLP fixation, and 23 patients (10 men, 13 women; 52.1 +/- 4.6) underwent closed reduction and external fixation. The follow-up period was at least 12 months and the mean following time was 13.5 +/- 1.02 (12-15) months. The functional parameters measured were range of motion (ROM) and grip strength. Radiographic parameters (radial inclination, palmar tilt, and radial height) and isokinetic evaluation were measured at the 6 months and at the final follow-up after surgery. The isokinetic test was done at the speed of 60 degrees/s. The non-fractured arm was tested first and all results were also expressed as a percentage of that on the normal side. Wrist scores according to the disability of the arm, shoulder, and hand (DASH) questionnaire were used. RESULTS: The DASH scores, grip strength, and palmar flexion were better in VLP group at the 6 months (p<0.05). However, there were no differences between two groups at the one year (p=0.79). Isokinetic evaluation of the VLP showed that peak pronation torque and total pronation work were better than external fixation at the 6 month (p<0.05). At the final of follow-up was seen no significant differences between two groups (p=0.11). CONCLUSION: We looked at external fixation and locked volar plates in a prospective study and we found an improved range of movement and isokinetic evaluation outcome at 6 months after locked plating, but there were no differences between two groups at the final of follow-up. Our study showed no evidence for the superiority of one treatment over the other at the final follow-up.