Nisanth, V S (2014) A comparative study of analysis of functional outcome of intra articular distal radius fractures treated with dynamic external fixator and locking compression plate. Masters thesis, Kilpauk Medical College, Chennai.
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Abstract
AIM OF THE STUDY: To analyze and compare the role and effectiveness of Closed reduction and External fixation with dynamic wrist fixator and Open reduction and Internal fixation with volar locking compression plate of intra articular distal radius fractures. MATERIALS AND METHODS: This comparative study is conducted in Govt. Kilpauk Medical College from March 2012 to December 2013. About 47 patients with intraarticular distal radius fractures were selected and randomly classified into two groups namely Ex Fix group and LCP group and treated with dynamic external fixator (penning type II) with or without supplementary techniques and volar locking compression plate respectively. 24 patients in Ex fix group and 23 patients in LCP group were treated among which 3 patients in Ex fix group and 2 patients in LCP group had lost follow up and so 21 patients in each group were analysed in the study. Average follow up is 12.84 months in Ex fix group and 11.26 months in LCP group. The results were analysed as functional outcome using Green and O’Brien score (modified by Cooney et al) and anatomical outcome using Lidstrom score. RESULTS: After proper analysis and doing statistical comparison, we got p- value of 0.568 for functional outcome and 0.468 for anatomical outcome which is considered insignificant. (significance of p value determined as <0.05). But with regard to individual parameters in the scores, we got significantly better results in the values of volar tilt, radial inclination and intraarticular step off in volar locking compression plate than dynamic external fixator. Regarding complications, among Ex fix group, 3 patients had superficial pin tract infection, one patient had deep infection, one had malunion and one had pin bending complications and among LCP group one had screw penetration into joint space and one had secondary collapse of the fracture. CONCLUSION: We conclude that there are no major differences in the functional outcome of both the techniques in terms of pain, range of movements, grip strength and return to work, in treating comminuted intra articular distal radius fractures. Eventhough there is no statistical difference in the functional outcome, volar locking compression plate plays a better role than dynamic external fixator in certain radiological parameters like volar tilt, radial inclination and intraarticular step off and also successful in achieving patient’s satisfaction with limited number of minor complications and early return to work.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Intraarticular distal radius fractures ; dynamic external fixator ; locking compression plate ; multiplanar ligamentotaxis ; volar approach to distal radius. |
| Subjects: | MEDICAL > Orthopaedics |
| Depositing User: | Subramani R |
| Date Deposited: | 16 Sep 2017 18:58 |
| Last Modified: | 16 Sep 2017 18:58 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/2992 |
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