Comparative Assessment of Functional Outcomes of Surgical Treatment in Patients with Distal Radial Fractures.

Abstract

Background: Unstable and comminuted distal radial fractures require surgical treatment by percutaneous insertion of Kir-schner wires, open reduction and fixation with a non-locking or locking plate or with an external device. The aim of this paper was to try to answer the following question: are there differences in functional treatment outcomes in patients after surgery with the use of Kirschner wires vs LCP plate fixation?

Material and methods: The study group included 100 patients after surgical treatment by closed reduction and simple fixation with Kirschner wires (50 patients) and by open reduction and LCP locking plate fixation (50 patients). The study assessed the following parameters: global grip strength, pain severity in a VAS scale, range of motion, functional status of the wrist based on the Fernandez classification, quality of life according to the QuickDASH score, and the frequency of complications. These parameters were assessed at 6 and 12 months after surgery.

Results: An assessment of the treatment outcomes at 6 and 12 months after surgery showed statistically significant differences between the treatment methods in the following parameters: pain severity, global grip strength and range of motion in the sagittal plane. A comparison of the functional status of the wrist at 6 and 12 months between the groups showed considerably worse results in the Kirschner wire fixation group. The frequency of postoperative complications at 12 months was 6% in the Kirschner wire fixation group and 2% in the LCP plate fixation group.

Conclusions: 1. Treatment outcomes were better in patients with distal radial fractures managed with LCP plate fixation. 2. The use of LCP plate fixation predisposes pa-tients to better ranges of mobility in the sagittal plane in the radiocarpal joint. 3.The values of global grip strength were higher in the group treated with LCP plate fixation. 4. Patients treated with LCP plates have better limb function and quality of life and lower pain intensity after treatment completion. 5. The number of complications was higher in pa-tients treated with Kirschner wire fixation.