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Fragment-Specific Fixation Versus Volar Locking Plates in Primarily Nonreducible or Secondarily Redisplaced Distal Radius Fractures : A Randomized Controlled Study

Landgren, Marcus LU ; Abramo, Antonio LU ; Geijer, Mats LU ; Kopylov, Philippe LU and Tägil, Magnus LU (2017) In The Journal of Hand Surgery 42(3). p.1-165
Abstract

Purpose: To compare the patient-reported, clinical, and radiographic outcome of 2 methods of internal fixation in distal radius fractures. Methods: Fifty patients, mean age 56 years (range, 21-69 years) with primarily nonreducible or secondarily redisplaced distal radius fractures were randomized to open reduction internal fixation using volar locking plates (n = 25) or fragment-specific fixation (n = 25). The patients were assessed on grip strength, range of motion, patient-reported outcome (Quick Disabilities of the Arm, Shoulder, and Hand), pain (visual analog scale), health-related quality of life (Short Form-12 [SF-12]), and radiographic evaluation. Grip strength at 12 months was the primary outcome measure. Results: At 12 months,... (More)

Purpose: To compare the patient-reported, clinical, and radiographic outcome of 2 methods of internal fixation in distal radius fractures. Methods: Fifty patients, mean age 56 years (range, 21-69 years) with primarily nonreducible or secondarily redisplaced distal radius fractures were randomized to open reduction internal fixation using volar locking plates (n = 25) or fragment-specific fixation (n = 25). The patients were assessed on grip strength, range of motion, patient-reported outcome (Quick Disabilities of the Arm, Shoulder, and Hand), pain (visual analog scale), health-related quality of life (Short Form-12 [SF-12]), and radiographic evaluation. Grip strength at 12 months was the primary outcome measure. Results: At 12 months, no difference was found in grip strength, which was 90% of the uninjured side in the volar plate group and 87% in the fragment-specific fixation group. No differences were found in range of motion and the median Quick Disabilities of the Arm, Shoulder, and Hand score was 5 in both groups. The overall complication rate was significant, 21% in the volar locking plate group, compared with 52% in the fragment-specific group. Conclusions: In treatment of primarily nonreducible or secondarily redisplaced distal radius fractures, volar locking plates and fragment-specific fixation both achieve good and similar patient-reported outcomes, although more complications were recorded in the fragment-specific group. Type of study/level of evidence: Therapeutic II.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Distal radius fracture, Fragment-specific fixation, Open reduction internal fixation, Randomized trial, Volar locking plate
in
The Journal of Hand Surgery
volume
42
issue
3
pages
1 - 165
publisher
Elsevier
external identifiers
  • pmid:28089163
  • wos:000396639600002
  • scopus:85009480693
ISSN
0363-5023
DOI
10.1016/j.jhsa.2016.12.001
language
English
LU publication?
yes
id
d7742097-69e2-4749-840f-2f210a2a4069
date added to LUP
2017-02-10 12:36:01
date last changed
2022-04-16 23:19:37
@article{d7742097-69e2-4749-840f-2f210a2a4069,
  abstract     = {{<p>Purpose: To compare the patient-reported, clinical, and radiographic outcome of 2 methods of internal fixation in distal radius fractures. Methods: Fifty patients, mean age 56 years (range, 21-69 years) with primarily nonreducible or secondarily redisplaced distal radius fractures were randomized to open reduction internal fixation using volar locking plates (n = 25) or fragment-specific fixation (n = 25). The patients were assessed on grip strength, range of motion, patient-reported outcome (Quick Disabilities of the Arm, Shoulder, and Hand), pain (visual analog scale), health-related quality of life (Short Form-12 [SF-12]), and radiographic evaluation. Grip strength at 12 months was the primary outcome measure. Results: At 12 months, no difference was found in grip strength, which was 90% of the uninjured side in the volar plate group and 87% in the fragment-specific fixation group. No differences were found in range of motion and the median Quick Disabilities of the Arm, Shoulder, and Hand score was 5 in both groups. The overall complication rate was significant, 21% in the volar locking plate group, compared with 52% in the fragment-specific group. Conclusions: In treatment of primarily nonreducible or secondarily redisplaced distal radius fractures, volar locking plates and fragment-specific fixation both achieve good and similar patient-reported outcomes, although more complications were recorded in the fragment-specific group. Type of study/level of evidence: Therapeutic II.</p>}},
  author       = {{Landgren, Marcus and Abramo, Antonio and Geijer, Mats and Kopylov, Philippe and Tägil, Magnus}},
  issn         = {{0363-5023}},
  keywords     = {{Distal radius fracture; Fragment-specific fixation; Open reduction internal fixation; Randomized trial; Volar locking plate}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{1--165}},
  publisher    = {{Elsevier}},
  series       = {{The Journal of Hand Surgery}},
  title        = {{Fragment-Specific Fixation Versus Volar Locking Plates in Primarily Nonreducible or Secondarily Redisplaced Distal Radius Fractures : A Randomized Controlled Study}},
  url          = {{http://dx.doi.org/10.1016/j.jhsa.2016.12.001}},
  doi          = {{10.1016/j.jhsa.2016.12.001}},
  volume       = {{42}},
  year         = {{2017}},
}