Abstract
Introduction: Current fixation methods for distal radial fractures usually involve immobilisation, which has been suggested to have adverse effects on wrist function. The aims of this study were to compare the clinical, functional and radiological outcomes of a bridging, and a non-bridging external fixator that did not cross the wrist joint, in the management of intra-articular fractures of the distal radius.
Methods: Sixty subjects were randomly allocated to receive a bridging Hoffman frame and limited wrist range of movement (ROM) exercises for 6 weeks, or a non-bridging Delta frame and full active wrist ROM exercises commencing at 2 weeks. All frames were removed at 6 weeks. Radiographic and clinical assessments were made at regular postoperative time intervals for 12 months with clinical outcomes including measures of pain, ROM, grip strength, function and quality of life.
Results: Preliminary clinical results analysing pain, grip strength and ROM including flexion, extension, pronation and supination at 1–6, 26 and 52 weeks postoperatively indicated that no statistically significant difference could be detected between the two groups at any time frame. Complication rates were similar for both groups. Preliminary radiographic analysis of dorsal angle, radial angle and radial length at 6, 26 and 52 weeks postoperatively also indicated that no statistically significant difference could be detected between the two groups.
Conclusion: Preliminary results of this trial suggest that no difference can be detected in the clinical and radiographic outcomes of subjects receiving a bridging external fixator with limited early wrist ROM exercises, or a non-bridging external fixator with early full active ROM exercises in the management of intra-articular fractures of the distal radius.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
