COMPARATIVE STUDY OF FUNCTIONAL OUTCOME IN PATIENT WITH FRACTURE OF DISTAL END RADIUS TREATED EITHER WITH PERCUTANEOUS K WIRE FIXATION OR VOLAR PLATING WITH LOCKING SCREWS

Abstract

Background: Fracture DER constitutes one of the most common skeletal injuries treated by the orthopaedician. This type of fracture[1]usually results from low Energy trauma in the elderly patients[2,3]. We assessed the outcome of volar plating and compared with  closed reduction and K Wire fixation of treatment to confirm satisfactory reduction and functional outcomes.

Method: In present  study, 90 cases of both extra articular and intraarticular distal end radius fracture  between age 20 to 65 years treated with closed reduction with K wire fixation + cast and  Volar plating with locking screws, it is a prospective study conducted at GMC Bhopal between 2019-2022.

Results: The most common mode of injury was fall on outstretched hand (FOOSH)(65%), with male preponderance(60%) and right side more common in both the group. In both the group average age was 45.90±10.16 year. According to AO classification, AO type A[5] was more common in both the group. Higher complications seen in closed reduction with K Wire + cast group. According to Gartland and Werley Score[4] results found in closed reduction with Percutaneous K Wire fixation+cast, 7 patient had excellent , 20-good , 13-fair and 5-poor results. In Volar plating with locking screws group, 10 patient had excellent results , 24-good , 9-fair , 2 poor results.

Conclusions: Unstable extra-articular and some  intra-articular fracture were reduced Anatomically, and fixed with k-wires percutaneously. Intra-articular displaced volar barton’s fracture were Treated by ORIF with Ellis Volar plate and locking screws. The anatomical and functional end result were significantly better With Volar plating with locking screws at final follow up.

Keywords: Distal End Radius (DER) fracture, Close reduction, Percutaneous Kirschner wire fixation, Volar Plating, Distal end extra and intra articular radius fracture, FOOSH