Comparison of external fixation and volar plate osteosynthesis in distal radius fractures

We compared the clinical and radiological results of external fixator augmented with Kirschner wires and volar locking plate techniques, which are frequently preferred in the surgical treatment of distal radius fractures, in patients with similar fracture patterns. In our study, among the patients who were operated with the diagnosis of distal radius fracture in our clinic between March 1, 2013 and March 1, 2019; 38 fractures of 38 patients who underwent osteosynthesis with external fixator augmented with Kirschner wires were evaluated retrospectively as Group 1 and 39 fractures of 39 patients who underwent osteosynthesis with volar locking plate as Group 2. In this evaluation; The range of motion of both wrists were measured with a goniometer, and the postoperative GRIP Score (grip strength) of the fractured side and intact side was measured in kilograms with a hand dynamometer. The QDASH score consisting of a series of questions was examined in all patients. Postoperative complications were evaluated from the records of past outpatient clinic examinations. Volar tilt angle, radial inclination angle, radial height, ulnar variance positivity, Stewart Score were evaluated radiologically. The QDASH score was 5.11 in Group 1 and 13.25 in Group 2, and this result was statistically significantly better in Group 1. In Group 1, postoperative radial height was 12.82, radial inclination was 26.45 and volar tilt was 6.84; In Group 2; postoperative radial height was 11.69, radial inclination was 23.18 and volar tilt was 9.83. Postoperative radial height and radial inclination were in Group 1, and postoperative volar tilt; It was found to be statistically significantly higher in Group 2. In group 1, postoperative flexion was 66.32 degrees, extension was 68.95 degrees, and ulnar deviation was 28.42 degrees. In Group 2, postoperative flexion was 59.74 degrees, extension was 59.87 degrees, and ulnar deviation was 33.97 degrees. Postoperative flexion and extension are in Group 1, and postoperative ulnar deviation is; It was found to be statistically significantly higher in Group 2. Although it was concluded in our study that osteosynthesis with external fixator provided better results than osteosynthesis with volar plate, external fixator supported with both volar locking plate and Kirschner wires provides successful results in distal radius fractures.