ORIF OR K WIRE STABILISATION FOR DISTAL RADIAL FRACTURES

Aim: To compare the outcome of open reduction and internal fixation with MUA and k-wire stabilisation of dorsally displaced distal radial fractures Methods: A review of patients that had ORIF or MUA and k-wire stabilisation for dorsally displaced distal radial fractures was carried out and patients with a follow period of more than 6 months were selected for this study. The patient history and the management of the injury were obtained and the wrist examined. Each patient completed a patient-rated wrist evaluation form and the range of movement and strength of the wrist was determined by the senior occupational therapist. Standard radiographs were obtained and volar tilt, radial inclination and radial length were measured. Results: This study provides results on 24 patients, which were grouped according to the two different surgical procedures; ORIF and MUA and k-wire stabilisation. The procedure undertaken depended on consultant preferences and in the majority of cases patients were treated with MUA and k-wire stabilisation. Patients of both groups were of similar age and all sustained either a low or medium energy injury. All patients from each group received physiotherapy post operatively. There was no significant difference between both groups for range of movement and grip strength. There was also no difference between the patient’s perception of pain and function which was assessed using the patient rated wrist evaluation (PRWE). Radiologically, the k-wire stabilisation group averaged better volar tilt compared with the ORIF group. For radial height and inclination the outcome was similar. Conclusion: MUA and k-wire stabilisation has been the most popular surgical management for unstable dorsally displaced fractures of the distal radius. More recently ORIF with the locking compression plate has been used with good results. This study showed that the outcome of ORIF and MUA and k-wire stabilisation were similar and therefore either surgical management can be used with good results.