To compare the functional outcome of distal radius fractures treated with closed reduction and cast application versus volar plating

Background: Fractures of distal radius account for 20% of all fractures treated in emergency department. These fractures result from low energy injuries in elderly population and high energy injuries in young adults. Most of these fractures are relatively uncomplicated and are effectively treated by closed reduction and casting. However, fractures that are unstable intra-articular can jeopardize the integrity of the articular congruence and kinematics of articulations resulting in high prevalence of complications. So to overcome these above complications, there is a shifting trend towards surgical management.

Aim: To compare the functional outcome of distal end radius fractures treated with closed reduction and cast application versus volar plating in our institution.

Methods: A randomized prospective interventional study was done in our institution in which all the patients of distal end of radius fractures were included as per inclusion and exclusion criteria. 30 patients were included in the study and followed up to 6 months. They were distributed equally into two groups i.e. 15 patients were treated surgically and the rest 15 conservatively. As all the patients were having similar characteristics, therefore no difference was noted among the groups w.r.t. demographic information. Patients were recommended for follow up at 6 days, 6 weeks, 3months and 6 months interval and routine x-rays were taken and dash scoring done to assess the functional recovery.

Results: 30 patients were included in this study and followed up to 6 months. The Affected limb DASH score at 6 months was compared in operative and no operative patients. In current study, Good score of Affected hand post-reduction dash score at 3 months was significantly more among Operative management. Fair score was significantly more among Conservative management. Excellent score at 6 months was significantly more among Operative management.

Conclusion: It can be concluded that surgical intervention for fracture distal end radius reduces chances of wrist joint stiffness and loss of reduction which gave good functional results as compared to conservative intervention. Hence, in our opinion surgical intervention for treatment of fracture distal end radius is a good method with excellent outcome.