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Comparison of external fixation, locking and non-locking palmar plating for unstable distal radius fractures in the elderly

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Abstract

This study compares the effectiveness of locking and non-locking palmar plating and external fixation for unstable distal radius fractures in the elderly. In a retrospective match-paired study, 45 patients aged 50 to 70 years who underwent surgery for C1/C2 distal radius fractures were evaluated. The surgical procedures were external fixation or plating with locking or non-locking palmar plates. Radiological and functional outcomes were assessed. Outcomes according to Gartland and Werley, Martini and the Disability of the Arm, Shoulder and Hand (DASH) questionnaire were compared. The locking palmar plate fixation method demonstrated significantly better radiological and functional results in comparison to external fixation and the non-locking palmar plating methods. The subjective assessment of plate fixation proved to be better than that of external fixation. Complications and reoperations were fewer for both plate fixation groups. Our data indicates that most displaced intra-articular distal radius fractures can be treated successfully with the locking palmar plate.

Résumé

cette étude a pour but de comparer les synthèses par plaques verrouillées ou non verrouillées ou la fixation externe pour fracture instable du radius distal, chez les personnes âgées. nous avons réalisé une étude rétrospective, comparative chez 45 patients âgés de 50 à 70 ans qui ont tous bénéficié d’une chirurgie après fracture du radius distal. Le traitement chirurgical a été soit une fixation externe soit une ostéosynthèse par plaque verrouillée ou non verrouillée. Les résultats ont été appréciés sur le plan radiologique et fonctionnel selon Gartland et Werley, Martini et le questionnaire Dash. la plaque palmaire verrouillée démontre à l’évidence un meilleur devenir fonctionnel et radiologique en comparaison à la fixation externe ou à la plaque palmaire non verrouillée. Les complications et les ré-interventions ont été moins importantes dans les deux groupes plaque. Ces données permettent donc de confirmer que la plupart des fractures de ce type peuvent être traitées avec succès à l’aide de plaques palmaires verrouillées.

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Authors and Affiliations

  1. Department of Hand and Plastic Surgery, University of Heidelberg, Heidelberg, Germany

    N. Schmelzer-Schmied, P. Wieloch, A. K. Martini & W. Daecke

  2. Department of Orthopaedic Surgery, University of Heidelberg, Heidelberg, Germany

    N. Schmelzer-Schmied, P. Wieloch, A. K. Martini & W. Daecke

  3. Department of Trauma, Hand and Reconstructive Surgery, Theodor Stern Kai 7, 60590, Frankfurt am Main, Germany

    W. Daecke

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  1. N. Schmelzer-Schmied
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  2. P. Wieloch
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  3. A. K. Martini
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  4. W. Daecke
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Correspondence to W. Daecke.

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Schmelzer-Schmied, N., Wieloch, P., Martini, A.K. et al. Comparison of external fixation, locking and non-locking palmar plating for unstable distal radius fractures in the elderly. International Orthopaedics (SICOT) 33, 773–778 (2009). https://doi.org/10.1007/s00264-007-0504-9

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  • DOI: https://doi.org/10.1007/s00264-007-0504-9

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