Is direct reduction and rigid fixation osteosynthesis better than ligamentotaxis for comminuted intra articular lower end radius fractures?

Abstract

Introduction: The distal radius has a complex kinematics for the radiocarpal and the radioulnar joints. Perfect restoration of the radial length, volar angulation and radial inclination are mandatory for complete restoration of the wrist function. Ligamentotaxis, and Open Reduction with Internal Fixation (ORIF) are the most commonly practiced two methods, to achieve the above goals in the current era of Orthopedic Practice. In this study, the functional and radiological outcomes of both Direct Reduction and Rigid fixation (ORIF with Volar Plating) and Ligamentotaxis were analyzed, to find out the best option among the two.Materials and Methods: This Prospective study was conducted in Department of Orthopedics KMCT medical college, a tertiary level health delivery institution in South India, from April 2017 to September 2018, of age group, 20 to 70 years, with Isolated closed distal end radius fracture not older than two weeks and classified as AO TYPE C -Distal end radius fracture. Those with Pregnancy, Polytrauma, other injuries in ipsilateral limb and presence of space occupying lesion at wrist were excluded from the study. Twenty patients were selected for each group, and the results were statistically analyzed using Statistical Package for Social Sciences (SPSS) 20.0 software.Results and Conclusions: In our study, on the analysis of the functional and radiological outcomes, we found there are significant advantages for volar locking plate over Ligamentotaxis, as early mobilization of the wrist and less intra/post-operative complications. Hence, it is definitely a better choice for managing Comminuted Intra Articular Distal End Radius Fractures.