A Comparative Prospective Study Between Ligamentotaxis Versus Volar Plating in Displaced Intra-articular Fractures of Distal End Radius in Adults.

OBJECTIVES

The objectives of the study are to compare the efficacy of external fixator/ligamentotaxis and volar plating in the treatment of displaced intra-articular distal end radius fracture by comparing the functional outcome using the Green and O'Brien score and to assess the radiological outcome of displaced intra-articular distal end radius fracture treated with external fixator/ligamentotaxis and volar plate.

METHODS

This randomized study was done on 70 patients from August 2022 to May 2024 at GIMSR Medical College and Hospital. We enrolled 35 patients in the volar plating and 35 patients in the external fixation groups. Functional outcomes were assessed at 3 and 6 months using Cooney modification of Green and O'Brien scores, and radiological outcomes were evaluated using Sarmiento radiological score.

RESULTS

By 6 months, both groups had comparable functional outcomes. The volar plating group achieved excellent results in 71.4% of cases, compared to 48.5% in the external fixation group. Radiological parameters like palmar tilt, radial shortening, and deviation showed no significant differences. Complications were similar between groups. Superficial pin tract infections were found to be common in the external fixation group and surgical site infections in the volar plating group.

CONCLUSION

Volar plating provided superior early functional outcomes, particularly in grip strength; however, both methods show comparable long-term results. Treatment choice should consider patient-specific factors, including bone quality and the need for early mobilization.

LEVEL OF EVIDENCE: I.