Keywords : Extra-articular
A PROSPECTIVE COMPARATIVE STUDY OF FUNCTIONAL OUTCOME OF DISTAL RADIUS DISPLACED EXTRA ARTICULAR FRACTURES TREATED BY CONSERVATIVE VERSUS OPERATIVE METHODS IN TERTIARY HEALTH CARE HOSPITAL.
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 117-126
Background: Fractures of the distal radius are one of the most common injuries seen in our day-to-day practice. It accounts for almost 4% of the injuries seen in the emergency department. Despite its high incidence and the substantial possible implications of suboptimal management, no high-level evidence regarding the best treatment method yet exists.
Aim: Aim of the study is to compare the functional outcomes of extra articular distal radius displaced fractures managed surgically with those managed conservatively.
Materials and Methods: In this prospective cohort study conducted between November 2020 to December 2021, 18 to 65 years old patients with displaced extraarticular distal radial fracture were treated surgically or conservatively. Modified Mayo Wrist Score were calculated after a follow up of 12 months.
Results: At the end of 12 months the patients were evaluated, and it was noticed that patients who were treated surgically had significantly better functional and clinical outcomes, as indicated by significantly higher Mayo scores than patients treated conservatively by casting (all p values < 0.05).
Conclusions: Patients treated with volar plate fixation were able to resume activities of daily living few weeks earlier compared to those managed with K-wire fixation and conservative group. Therefore, we can conclude that volar plate fixation gives significantly better clinical and functional results than other methods of treatment.
Functional outcome and radiological union in operated cases of AO type 12-B1 fractures of distal shaft humerus with interfragmentary screws and lateral anatomical plate
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 2, Pages 1568-1581
Background: Extra-articular distal shaft humerus fractures at the junction of cylindrical and triangular portion are seen as torsion wedge fractures. Historically most shaft fractures were treated conservatively. Today’s trend is towards surgical management due to high patient demand and availability of anatomical plates. This study aims to evaluate the functional results of plating in extra-articular distal humerus fractures with duration of clinical and radiological union.
Methods: A prospective study of 20 patients with torsion wedge fractures of AO Type 12-B1 was done over a period of 3 years. Demographic data was collected and all patients underwent fixation with posterior triceps splitting approach using an extra-articular distal humerus plate (EADHP) and inter-fragmentary screws. Results were evaluated by clinical and radiographic parameters. Functional results were monitored by modified Quick DASH score.
Results: There were 12 males and 8 females with a mean age of 34.45 years. Mean time to clinical and radiographic union was 10.5 weeks and 33.9 weeks respectively. The mean modified Quick DASH score at clinical and radiographic union was 24.8% and 13.76% respectively. Two patients developed radial nerve neuropraxia recovering spontaneously. One patient having inadequate reduction went on to unite both clinically and radiographically with good functional out come without any secondary intervention.
Conclusion: AO Type 12-B1 humerus fractures treated surgically with anatomical locking plates and inter-fragmentary screws give excellent anatomical and functional results. Though time to radiographic union is prolonged, no secondary intervention in the form of bone grafting or other modalities was required in any patient.