Functionality of Fractures Distal Radius Joints Treated with Volar Plate Versus Fixator External: Evidence from A Regional Hospital in Veracruz, Mexico
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Abstract
Background : Distal radius fractures are among the most common upper-limb injuries, and their treatment plays a key role in restoring wrist function . Two common surgical methods —volar locking plate and external fixator — remain under debate regarding functional superiority in the early postoperative Period .
Objective : To compare functional outcomes of intra-articular distal radius fractures treated with volar locking plate versus external fixation in a regional hospital in Mexico
Methods : Comparative observational study including 136 surgically treated patients evaluated using the PRWE scale at 6 weeks and 3 months postoperatively
Results : At 6 weeks , the external fixator group had a mean PRWE score of 87.41 compared with 56.85 in the volar plate group . In 3 months , scores improved but differences remained significant (36.84 vs 25.82; p < 0.001).
Conclusion : The volar locking plate provides faster and superior early functional recovery compared with external fixation . External fixation remains useful for selected cases but tends to show slower functional improvement .
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References
I. Martín Blanco Silvia, Minaya García Javier, Barberá Loustaunau María José, Vaca Fernández Patricia Lucía, Juncal Barrio Velasco Marta. Distal radius fractures : a comparison radiological according to degree of instability and treatment Received . New Hospital. 2020;16(1):2-7.
II. Alfaro Pacheco Ricardo, Gómez García Daniel. Management of distal radius fractures in emergencies . Rev Méd Sinerg . 2024;9(1 ):e 1129.
III. Garg Rajesh, Mudgal Chaitanya S. When a volar locking plate is not the right choice in fractures of the distal radius: case based technical considerations. J Clin Orthop Trauma. 2020;11(4):542-53. doi:10.1016/j.jcot .2020.05.040
IV. Sobel Adam D, Calfee Ryan P. Distal radius fractures in the athlete. Clin Sports Med. 2019;38(3):457-68. doi:10.1016/j.csm .2019.10.005
V. Pancorbo Sandoval Ernesto A, Delgado Quiñones Armando, Díaz Prieto Guillermo. Current Affairs about he consensus of classification systems in distal radius fracture. Rev Cubana Med Mil. 2021;50(4 ) :e 200.
VI. Dündar Ahmet. Volar-locking plate versus external fixator in the management of distal radius fractures: an isokinetic study. Ulus Travma Acil Cerrahi Derg . 2021;27(4):478-84. doi:10.14744/tjtes.2021.72606
VII. Polat Onur, Toy Savaş, Özbay Hakan. Combined plate versus external fixation for distal radius fractures. Acta Ortop Bras. 2023;31(spe1 ):e 252977. doi:10.1590/1413-785220233101e252977
VIII. Ali Fazal Muhammad, Denis Mitchell Christopher, Ashwood Nicholas. Volar locking plate: age-related outcomes and complications. J Clin Orthop Trauma. 2020;11(4):642-5. doi:10.1016/j.jcot .2020.05.025
IX. , Delgado-Bueno Susana, Ramírez-Iñiguez de la Torre María Victoria. Assessment questionnaires functional in Traumatology . Cuban Journal Orthopedics Traumatol . 2019;33(1 ):e 164.
X. Gómez-Eslava Bibiana, Rodriguez-Ricardo María Camila, Serpa Juan Camilo, Fajury Ricardo, García-González Luis Alberto. Cross-cultural adaptation and validation of the translated Patient-Rated Wrist Evaluation Score. J Wrist Surg. 2021;10(4):303-7. doi:10.1055/s-0041-1725173
XI. Rodríguez Daniel A, Seery Eoghan, Valdivieso Gabriel, Peso Francisco L, Fuertes Luis E, Brondo Carlos E, et al. Version Argentine version of the Patient-Rated Wrist Evaluation questionnaire : translation , cross-cultural adaptation and evaluation of properties psychometrics . Argent J Respir Phys Ther. 2019;1(2):24-33.
XII. Gou Qiang, Xiong Xiaoming, Cao Dong, He Yong, Li Xin. Volar locking plate versus external fixation for unstable distal radius fractures: a systematic review and meta-analysis based on randomized controlled trials. BMC Musculoskelet Disord . 2021;22(1):436. doi:10.1186/s12891-021-04312-7
XIII. Yu Xiang, Yu Yiming, Shao Xing, Bai Yuchen, Zhou Tao. Volar locking plate versus external fixation with optional additional K-wire for treatment of AO type C2/C3 fractures: a retrospective comparative study. J Orthop Surg Res. 2019;14(1):271. doi:10.1186/s13018-019-1309-4
XIV. Maccagnano Giuseppe, Noia Giuseppe, Vicenti Gabriele, Baglioni Marco, Masciale Marco R, Cassano Giovanni D, et al. Volar locking plate versus external fixation in distal radius fractures: a meta-analysis. Orthop Rev (Pavia). 2021;13(1):9147. doi:10.4081/or.2021.9147
XV. Dabash Shady, Potter Edward, Pimentel Eduardo, Shunia Jad, Abdelgawad Amr, Thabet Ahmed M, et al. Radial plate fixation of distal radius fracture. Hand (NY). 2020;15(1):103-10. doi:10.1177/1558944718787290
XVI. Schindelar Lisa E, Ilyas Asif M. Plate fixation of distal radius fractures. Hand Clin. 2021;37(2):259-66. doi:10.1016/j.hcl .2021.02.008
XVII. Gullón Martínez Laura, Hernández Jurado Nicolás, Moreno López Raúl, Aranda Andreu Sara, Giménez Salvador Eva, Salvador Lanzuela Silvia. Distal radius fracture . Rev Sanit Investig . 2024;5(4).
XVIII. Sharma Ankit, Pathak Sumit, Sandhu Hardeep, Bagtharia Priyank, Kumar Nitin, Bajwa Rajinder S, et al. Prospective randomized study comparing the external fixator and volar locking plate in intra-articular distal radius fractures: which is better? Cureus. 2020;12(2):e 6849. doi:10.7759/cureus.6849
XIX. Mishra Rajesh Kumar, Singh Amit, Pandey Vivek, Kumar Manish, Gaurav Ravi, Yadav Arvind, et al. A comparative study of variable angle volar plate and K-wire augmented bridging external fixator. Chin J Traumatol . 2021;24(5):267-72.
XX. Yılmaz Mehmet. Comparison of the clinical and radiological results of volar locking plate and external fixation treatment of intra-articular fractures of the distal radius. Arch Basic Clin Res 2023;5(1):17-23.
XXI. Jafari Davood, Esmaeilnejad Fatemeh, Naderi Amir, Rahmani Abbas, Ghaffarzadeh Maryam, Hoseinzadeh Ali, et al. Treatment outcomes of applying external fixator on distal radius fractures. BMC Musculoskelet Disord . 2023;24(1):178. doi:10.1186/s12891-023-06642-3
XXII. Agarwal Sandeep, Sharma Rajeev, Gupta Neeraj, Yadav Sunil, Singh Mohit, Verma Deepak, et al. Volar plating versus external fixator with cross K-wire for distal radius fracture: a comparative study. J Orthop Case Rep 2022;12(3):45-50.
XXIII. Yang Jun, Li Wei, Zhou Jian, Tang Lei, Chen Qiang, Zhao Ming, et al. Meta-analysis comparing volar locking plates and other fixation methods for distal radius fractures. Indian J Orthop . 2024;58(1):15-25.
XXIV. Nwosu Chukwudi, Onuoha Kingsley, Ezeonwu Peter, Anike Emmanuel, Nwabude Ikenna, Ugwoke Charles, et al. Complications following volar locking plate fixation of distal radius fractures. J Hand Surg Am. 2023;48(3):245-53.
XXV. Comparative study: volar plate fixation vs external fixation in distal radius fractures. Orthopaper . 2022;8(4):77-82.
XXVI. Baz Mohamad, Rahman Ahmed, Hossain Kamal, Ahmed Tarek, Chowdhury Mahmud, Sultana Fatema, et al. Comparison of volar locking plate versus external fixation with additional K-wires for displaced distal radius fractures. Cuest Physioter . 2024;53(2):89-96.
XXVII. Singh Abhishek, Patel Rahul, Meena Saurabh, Sharma Deepak, Khan Arif, Study on outcome of distal end radius fracture in adults managed by volar locking plate versus external fixation. NeuroQuantology . 2022;20(4):117-25.
XXVIII. Carroll Thomas J, Johnson Peter R, Evans Matthew, Baker Sarah, Hughes Paul. Clinical and radiographic outcomes following volar plating of distal radius fractures. J Orthop Clin Res 2023;11(2):140-8.
XXIX. Kumar Ashok, Mehta Varun, Singh Sandeep, Gupta Rajiv, Prospective comparative study: volar plate vs external fixation in distal radius fractures. Int J Health Sci Res. 2023;13(6):92-101.
XXX. Jayaram Manjunath, Patel Ritesh, Dutta Arindam, Kulkarni Ajay, Reddy Vishal, Network meta-analysis of fixation methods for distal radius fractures: comparison of volar locking plate and external fixation. JAMA Network Open. 2023;6(9 ):e 2330501. doi:10.1001/jamanetworkopen.2023.30501