dc.contributor.author | Ludvigsen, Trine | |
dc.contributor.author | Matre, Kjell | |
dc.contributor.author | Gudmundsdottir, Rakel Sif | |
dc.contributor.author | Krukhaug, Yngvar | |
dc.contributor.author | Dybvik, Eva Hansen | |
dc.contributor.author | Fevang, Jonas Meling | |
dc.date.accessioned | 2021-08-18T08:29:42Z | |
dc.date.available | 2021-08-18T08:29:42Z | |
dc.date.created | 2021-07-07T11:47:13Z | |
dc.date.issued | 2021 | |
dc.identifier.issn | 0021-9355 | |
dc.identifier.uri | https://hdl.handle.net/11250/2770012 | |
dc.description.abstract | Background:
The use of volar locking plate fixation (VLP) for unstable extra-articular distal radial fractures has increased in the last decades. External fixation (EF) is less frequently used. This change of surgical approach has only to some extent been evidence-based.
Methods:
In this multicenter, randomized controlled trial, we compared VLP and EF in patients between 18 and 70 years of age who had a displaced extra-articular distal radial fracture (OTA/AO type A3). The patients were examined at 6 weeks, 3 months, and 1 year postoperatively. The primary outcome measure was the Patient-Rated Wrist/Hand Evaluation score (PRWHE). Secondary outcomes were the shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH), pain score on a visual analog scale (VAS), and radiographic measurements. Range of motion, grip strength, finger stiffness, complications, and reoperations were also recorded.
Results:
One hundred and fifty-six patients were included. One hundred and forty-two (91%)—127 women (89%) and 15 men (11%)—completed 1 year of follow-up. Sixty-nine patients were treated with VLP and 73, with EF. The mean age was 56 years. At 6 weeks, the median PRWHE score was significantly higher in the EF group (44) compared with the VLP group (27) (p < 0.001). At 3 months and 1 year, the difference between groups was not significant. The median QuickDASH score was 27 in the VLP group and 43 in the EF group at 6 weeks (p < 0.001), and a significant difference persisted at 3 months (p = 0.023). The VLP group had superior results in terms pain during activity, wrist extension, and ulnar and radial deviation at 1 year, whereas the number of major complications was similar in the 2 groups.
Conclusions:
Patients treated with VLP had earlier recovery of function compared with patients treated with EF. One year postoperatively, we found no significant functional difference. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Lippincott, Williams & Wilkins | en_US |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internasjonal | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/deed.no | * |
dc.title | Surgical Treatment of Distal Radial Fractures with External Fixation Versus Volar Locking Plate A Multicenter Randomized Controlled Trial | en_US |
dc.type | Journal article | en_US |
dc.type | Peer reviewed | en_US |
dc.description.version | publishedVersion | en_US |
dc.rights.holder | Copyright 2020 The Authors | en_US |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 2 | |
dc.identifier.doi | 10.2106/JBJS.20.00275 | |
dc.identifier.cristin | 1920661 | |
dc.source.journal | Journal of Bone and Joint Surgery. American volume | en_US |
dc.source.pagenumber | 405-414 | en_US |
dc.identifier.citation | Journal of Bone and Joint Surgery. 2021, 103 (5), 405-414. | en_US |
dc.source.volume | 103 | en_US |
dc.source.issue | 5 | en_US |