European Journal of Biomedical and Pharmaceutical Sciences

CLOSED REDUCTION AND PLASTER CAST IMMOBILIZATION VS. EXTERNAL FIXATION IN COMMINUTED INTRA-ARTICULAR FRACTURES OF DISTAL RADIUS

Dr. Venkata Kiran Pillella*

ABSTRACT

Background: Comminuted intra-articular fractures of distal radius often result in a painful, stiff, dysfunctional wrist. They may be treated by external fixators or by closed reduction and plaster. Methods: Fifty-five patients of comminuted, intra-articular fractures of distal radius were treated randomly either by closed reduction and plaster immobilisation or by external fixation. The radiological results, functional results and complications in both the groups were analyzed. Results: The outcome of external fixation was significantly better as compared to cast immobilization (p < .05). Incidence of loss of reduction was significantly improved by external fixation as compared to cast immobilization (p< .001). There was a strong positive correlation between restoration of normal anatomy (radiological results) and functional outcome (r= .811). Complications were seen in 43% of patients in POP group and 33% of patients in external fixator group. Conclusion: We conclude from this study that external fixator is a better modality of treatment as compared to plaster cast immobilization for intra-articular distal radial fractures. It is also reliable in maintaining the reduction of unstable fractures however it is inadequate in attaining anatomical reduction in many cases when used exclusively. Complications of external fixation, although less frequent than cast immobilization, are potentially serious in nature.

Keywords: Intra-articular fractures; Distal radius; External fixation.