Evaluation of Functional Outcome of Unstable Distal Radial Fracture Treatment: A Comparison between Internal & External Fixations

Distal radial fracture is the most common fracture of upper extremity in all age group. In recent years, fixation with distal radial locking plate and external fixator both have become widely accepted modalities for treating unstable distal radial fracture. Purpose of this study was to evaluate the functional outcome of unstable distal radial fracture (AO/OTA 2.3B2 to C3) treated by internal and external fixations. Sample size was60 with (AO/ OTA 2.3-B2 to C3) fracture as per set criteria and was treated either by distal radial locking plate or by external fixator. Quick DASH Score was used for evaluation of functional outcome of surgery. Out of 60 patients, male (75%) were more than female (25%), maximum age incidence was found in 46-55 years age group (31.7%), right side involvement was 68.3% and left side was 31.7%. Over 66% incidence was due to RTA. Type of injury was 11.7% B2, 18.3% B3, 43.3% C1, 20.0% C2 and 6.7% C3. External fixation was 58.3% and internal fixation was 41.7%. Mean ± SD duration of operation was 39.14 ± 7.017 minutes in external fixation group and 92.80 ± 21.703 minutes in internal fixation group. Functional outcome was75.9% good and 17.2% excellent in external fixation group and 52.2% good and 34.8% excellent in fixation with distal radial locking plate group according to Quick DASH Score. Postoperative complication like soft tissue infection 34.3% and delayed union 25.7% and wrist stiffness 74.3% was in external fixation group and in internal fixation group, patients had suffered from soft tissue infection 32% and wrist stiffness 56%. No patient had non-union. Mean ± SD radiological union time in external fixation group was 16.53 ± 5.386 weeks and in internal fixation group was 16.67 ± 5.264 weeks. After 12 months of surgery both external fixation and locked volar plating provide good to excellent clinical outcomes