Comparison of the volar locking plate and the bridging external fixator in the treatment of distal radius fracture based on range of wrist motion assessed by functional radiography

BACKGROUND: The authors hypothesized that an external fixator (EF) could compromise ROM compared with a volar locking plate (VP) because of the longer duration of immobilization using a VP. Postoperative ROM were therefore compared between the EF and the VP, focusing on the movement of the radiocarpal (RC) and midcarpal (MC) joints evident on radiology. The clinical outcomes of the two methods were also evaluated. MATERIAL/METHODS: Functional radiographs were taken in active volar and dorsal flexions from both the injured and contralateral sides. Clinical outcomes in terms of grip strength, pulp pinch, Quick-DASH, and the modified Cooney evaluation were compared. RESULTS: The average wrist volar flexion angle was significantly smaller on the injured side in both groups, significantly so in the VP group. No significant differences were seen in clinical outcome. Although distinct restriction of the wrist volar flexion angle was seen in patients treated with the VP, the Quick-DASH and the modified Cooney evaluation showed no difference between these two groups. CONCLUSIONS: These results should be considered when performing surgical treatment for patients with distal radius fracture. These procedures should be adopted to complement each other according to local conditions and individual patient-related factors.