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Open reduction and internal fixation compared to closed reduction and external fixation in distal radial fractures A randomized study of 50 patients

Abramo, Antonio LU ; Kopylov, Philippe LU ; Geijer, Mats LU and Tägil, Magnus LU (2009) In Acta Orthopaedica 80(4). p.478-485
Abstract
Background and purpose In unstable distal radial fractures that are impossible to reduce or to maintain in reduced position, the treatment of choice is operation. The type of operation and the choice of implant, however, is a matter of discussion. Our aim was to investigate whether open reduction and internal fixation would produce a better result than traditional external fixation. Methods 50 patients with an unstable or comminute distal radius fracture were randomized to either closed reduction and bridging external fixation, or open reduction and internal fixation using the TriMed system. The primary outcome parameter was grip strength, but the patients were followed for 1 year with objective clinical assessment, subjective outcome... (More)
Background and purpose In unstable distal radial fractures that are impossible to reduce or to maintain in reduced position, the treatment of choice is operation. The type of operation and the choice of implant, however, is a matter of discussion. Our aim was to investigate whether open reduction and internal fixation would produce a better result than traditional external fixation. Methods 50 patients with an unstable or comminute distal radius fracture were randomized to either closed reduction and bridging external fixation, or open reduction and internal fixation using the TriMed system. The primary outcome parameter was grip strength, but the patients were followed for 1 year with objective clinical assessment, subjective outcome using DASH, and radiographic examination. Results At 1 year postoperatively, grip strength was 90% (SD 16) of the uninjured side in the internal fixation group and 78% (17) in the external fixation group. Pronation/supination was 150 degrees (15) in the internal fixation group and 136 degrees (20) in the external fixation group at 1 year. There were no differences in DASH scores or in radiographic parameters. 5 patients in the external fixation group were reoperated due to malunion, as compared to 1 in the internal fixation group. 7 other cases were classified as radiographic malunion: 5 in the external fixation group and 2 in the internal fixation group. Interpretation Internal fixation gave better grip strength and a better range of motion at 1 year, and tended to have less malunions than external fixation. No difference could be found regarding subjective outcome. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
80
issue
4
pages
478 - 485
publisher
Taylor & Francis
external identifiers
  • wos:000269886400015
  • pmid:19857180
  • scopus:70350666537
ISSN
1745-3682
DOI
10.3109/17453670903171875
language
English
LU publication?
yes
id
9dd71c7c-2af1-4022-a982-e846fa380502 (old id 1490811)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19857180?dopt=Abstract
date added to LUP
2009-10-19 11:15:29
date last changed
2017-07-09 03:33:25
@article{9dd71c7c-2af1-4022-a982-e846fa380502,
  abstract     = {Background and purpose In unstable distal radial fractures that are impossible to reduce or to maintain in reduced position, the treatment of choice is operation. The type of operation and the choice of implant, however, is a matter of discussion. Our aim was to investigate whether open reduction and internal fixation would produce a better result than traditional external fixation. Methods 50 patients with an unstable or comminute distal radius fracture were randomized to either closed reduction and bridging external fixation, or open reduction and internal fixation using the TriMed system. The primary outcome parameter was grip strength, but the patients were followed for 1 year with objective clinical assessment, subjective outcome using DASH, and radiographic examination. Results At 1 year postoperatively, grip strength was 90% (SD 16) of the uninjured side in the internal fixation group and 78% (17) in the external fixation group. Pronation/supination was 150 degrees (15) in the internal fixation group and 136 degrees (20) in the external fixation group at 1 year. There were no differences in DASH scores or in radiographic parameters. 5 patients in the external fixation group were reoperated due to malunion, as compared to 1 in the internal fixation group. 7 other cases were classified as radiographic malunion: 5 in the external fixation group and 2 in the internal fixation group. Interpretation Internal fixation gave better grip strength and a better range of motion at 1 year, and tended to have less malunions than external fixation. No difference could be found regarding subjective outcome.},
  author       = {Abramo, Antonio and Kopylov, Philippe and Geijer, Mats and Tägil, Magnus},
  issn         = {1745-3682},
  language     = {eng},
  number       = {4},
  pages        = {478--485},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica},
  title        = {Open reduction and internal fixation compared to closed reduction and external fixation in distal radial fractures A randomized study of 50 patients},
  url          = {http://dx.doi.org/10.3109/17453670903171875},
  volume       = {80},
  year         = {2009},
}