Comparison of External Fixator Combined with Plate Compared to Plate Fixation Alone in the Treatment of Intra-Articular Comminuted Distal Radius Fractures

Najafi, Arvin; Behzadi, Milad; Azarsina, Salman; Mirhosseini, Mohammad Sajjad; Sheibani, Mohammad; Hadavi, Dorsa; Khandan, Elahe; Yaghoobnezhad, Mahdi

doi:10.22034/ijos.2025.551625.1177

Comparison of External Fixator Combined with Plate Compared to Plate Fixation Alone in the Treatment of Intra-Articular Comminuted Distal Radius Fractures

Document Type : Original Article

Authors

Arvin Najafi ¹ ^¶

Milad Behzadi ²

Salman Azarsina ¹

Mohammad Sajjad Mirhosseini ¹

Mohammad Sheibani ¹

dorsa hadavi ³

Elahe Khandan ⁴

mahdi yaghoobnezhad ¹

¹ Department of Orthopedic Surgery, Clinical Research Development Unit of Shahid Madani Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.

² Student Research Committee, School of Medicine, Clinical Research Development Unit of Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran.

³ Clinical Research Development Unit of Shahid Madani Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.

⁴ Student Research Committee, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

https://doi.org/10.22034/ijos.2025.551625.1177

Abstract

Abstract
Introduction: Distal radius fractures are the most common fractures in the upper limb, and many studies have been conducted on its treatment. There is, as yet, no consensus on which treatment method is preferable. This paper compares the use of plate alone with plate + external fixator in this fracture.
Materials & Methods: In a randomized clinical trial (RCT), patients with type C2 and C3.1(AO/OTA classification) distal radius fracture, were randomly divided into two groups of fixation with locking plate alone (control) and fixation with plate and additional external fixator (intervention). Then patients were evaluated in terms of radiographs and clinical outcomes in first, third and, sixth weeks, and also 6 and 9 months after surgery by Quick Disabilities of the Arm, Shoulder and Hand questionnaire (qDASH) and visual analogue score (VAS). SPSS software was used for data analysis. Informed consent was obtained from the patients.
Results & Discussion: 52 patient (26 in each group) were enrolled in the study. The mean age was 42 years in the control and 41 years in the intervention group. The qDASH score in the control group was 35 and 38 in the intervention group and this difference was not significant between the two groups. No significant difference was observed between the two groups in terms of pain level according to the (VAS) score either. Also, the radiographic criteria including radius height and palmar tilt, did not differ significantly between the two groups (p<0.05).
Conclusion: In general, with similar results of plating, and plating with addition of external fixator in fixation of distal radius fracture, the method of “plate alone” is preferred.

Keywords

Distal radius fracture, Fracture Fixation, External Fixators, Internal Fixators

Subjects