Comparison of functional outcomes for displaced extra-articular distal radius fractures managed by operative and non-operative methods: A prospective cohort study

Muhammed Nazeer, M. Nazeer, J. Kamath, H. Shetty, Harish Maheshan, Manesh Jain
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Abstract

: 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. The study aimed to compare the functional outcomes of extra articular distal radius fractures managed operatively with those managed conservatively. In this prospective cohort study conducted between November 2018 to September 2020, 18 to 65 years old patients with displaced extraarticular distal radial fracture were treated surgically or conservatively. DASH and Modified Mayo Wrist Score were calculated after a follow up of one year.: At the end of 12 months the patients were evaluated, and it was noticed that patients who were treated operatively 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). The DASH scores were lower in the patients who had undergone operative management. 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.
手术和非手术治疗移位性桡骨远端关节外骨折的功能结局比较:一项前瞻性队列研究
桡骨远端骨折是我们日常治疗中最常见的损伤之一。它占了急诊科所见伤害的近4%。尽管它的发病率很高,而且可能涉及到不理想的治疗方法,但目前还没有关于最佳治疗方法的高水平证据。该研究旨在比较手术治疗和保守治疗桡骨远端关节外骨折的功能结果。在2018年11月至2020年9月进行的这项前瞻性队列研究中,18至65岁的桡骨远端关节外骨折移位患者接受手术或保守治疗。随访1年后计算DASH和改良Mayo手腕评分。在12个月结束时对患者进行评估,注意到手术治疗的患者功能和临床结果明显更好,Mayo评分明显高于保守铸造治疗的患者(p值均< 0.05)。接受手术治疗的患者DASH评分较低。与k线固定和保守组相比,经掌侧钢板固定治疗的患者能够提前几周恢复日常生活活动。因此,我们可以得出结论,掌侧钢板固定比其他治疗方法具有更好的临床和功能效果。
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