Comparison of External Fixator Treatment Results with Dorsal Bridge Plating in Distal Radius Fracture

Abstract

Considering that comminuted fractures of the distal radius include a high share of orthopedic traumas and two methods of using external fixators and dorsal bridge plates are being performed at Shohada hospitsl, Tabriz, we decided to investigate the therapeutic results and evaluate the complications in these two methods; Therefore, the aim of this study is to compare the treatment results of external fixator with dorsal bridge plating in distal radius comminuted fracture. Materials and Methods: This prospective cross-sectional descriptive study was conducted in Shahada Hospital in Tabriz during the years 2022 and 2023 with the participation of 80 patients who were candidates for distal radius comminuted fracture surgery who underwent surgery using one of the two surgical methods with the help of an external fixator and surgery using the Dorsal bridge plate method. For all patients, a splint was installed for two weeks, and if signs of fusion were not observed in follow-up X-ray after two weeks, a splint was installed for the patients until the fourth week. The patients were discharged from the hospital the day after the surgery, and for further follow-up, they went to the relevant doctor's clinic at intervals of two weeks, four weeks, the third month, the sixth month, and the twelfth month after the surgery. Then, information such as the time between the injury and surgery, surgery time and complications such as nonunion, malunion, nerve damage, damage to the extensor tendon, and surgical site infection were also recorded for all patients. The final results at the end of one year included pain intensity in rest and activity state, hand strength, pinch strength and wrist ROM including flexion, extension, ulnar deviation, radial deviation, supination and pronation were measured. Results: The infection was significantly higher in the patients of the external fixator group than in the patients of the long-term plate group (P=003); Operation time was significantly lower in external fixator group (P=0.023). pain severity during resting (P=0.029) and functioning (P=0.021). pinch strength (P=0.027) in the patients of dorsal plate group were significantly higher than the external fixator group. Wrist flexion (P=0.021) and wrist extension (P=0.019) were significantly higher in patients with external fixator compared with dorsal plate group. Radial height (P=0.031), radial inclination angle (P=0.041) and palmar tilt (P=0.004) were significantly higher in the patients of Dursal plate group than in the external fixator group.