EVALUATION OF RESULTS OF FRACTURES OF DISTAL END OF RADIUS BY CONSERVATIVE AND SURGICAL MANAGEMENT- A COMPARATIVE STUDY

BACKGROUND Distal radius fractures are among the most common fractures of the upper extremity. The most common cause of this type of fracture is fall on outstretched hand. In young adults, this fracture is the result of fall from a significant height or motor vehicle accident. The purpose of this study was to evaluate the functional outcome of conservative and surgical management of distal radius fractures in adults using various methods such as closed reduction and K-wire fixation, External fixation and open reduction and internal fixation with plate and screws. MATERIALS AND METHODS A total of sixty cases of fractures of distal end radius belonging to various groups were treated by conservative and operative management. In operative group, out of 30 cases, there were 26 (87%) males and 4 (13%) females with mean age of 38.53 years. 18 (60%) patients had right side involvement (dominant wrist) and 12 (40%) had left side involvement. Of the 30 cases, injury occurred due to road traffic accident in 19 (63%) patients and fall on the out stretched hand in 11 (37%) patients. In conservative group, out of 30 cases, there were 12 (40%) males and 18 (60%) females between the age group of 21 - 90 years with mean of 53 years. 22(73%) patients had right side involvement (dominant wrist) and 8 (27%) had left side involvement. Of the 30 cases, injury occurred due to road traffic accident in 6 (20%) patients and fall on the out stretched hand in 24 (80%) patients. RESULTS Male predominance was seen in which 87% of cases were males. In conservative group, female predominance was seen in which 60% cases were females. Right side is predominantly involved than left with 18 (60%) cases in operative group and with 22(73%) cases in conservative group. CONCLUSION The mode of injury is either a road traffic accident or fall on the outstretched hand. Distal radial fractures which occur due to road traffic accidents (high energy trauma) were mostly intra-articular, displaced and unstable and those due to fall on the outstretched hand were extra-articular. The choice of a particular method of treatment for each case should depend on the fracture pattern, reducibility, stability and quality of bone. Fractures with extreme comminution are best fixed with distraction and external fixation. Radial length, which is the most important radiological parameter, is best maintained by external fixation due to sustained counter traction utilising the principle of ligamentotaxis. Kirschner wires were used for percutaneous pinning through direct imaging for extra articular fractures with adequate bone stock and application of below elbow cast for six weeks