Abstract :
Objective: To compare the outcomes of plaster casting and external fixation in comminuted distal radiusfractures.Methodology: This prospective study was conducted at District Headquarter Teaching Hospital andKhalifa Gul Nawaz Teaching Hospital Bannu from February 2009 to September 2010. A total of 30 adultpatients having comminuted distal radius fractures were included in this study. They were classifiedaccording to AO/ASIF-Classification. The patients were randomized to plaster casting and external fixationby lottery method. Follow-up of each case was done for a total duration of 12 weeks. Radiographicassessment and clinical evaluation was conducted during each visit. Any complications arising during thisperiod were recorded. The outcomes were assessed at the end of 12 weeks. For grading the results, Green O.Brien clinical scoring system was used.Results: Out of 30 patients, 15 were treated with plaster casting and 15 with external fixation. The meanage of patients in plaster casting group was 49.80 years + 16.05 SD and in external fixation group 51.47years + 15.01 SD. According to AO-Classification, there were 8 type- A, 10 type- B and 12 type- Cfractures. Radiographic evaluation at 12 weeks in plaster casting group showed mean values of volar tilt2.8667 º, radial height 6.0000 mm, radial inclination 14.2000 º and articular step-off 1.5200 mm. In theexternal fixation group, mean value of volar tilt was 5.7333 º, radial height 8.2000 mm, radial inclination18.8000 º and articular step-off 1.0467 mm. Clinical evaluation based on Green O Brien scoring systemshowed 4 excellent, 3 good, 4 fair and 4 poor results in plaster casting group and 5 excellent, 6 good, 2fair and 2 poor results in external fixation group.Conclusion: External fixation is an acceptable surgical solution for the treatment of comminuted distalradius fractures as compared to cast immobilization.
