Volar locking plates versus methods requiring immobilization for treatment of DRFs

Study Type: Therapy
OE Level of Evidence: 2
Journal Level of Evidence: 2
Synopsis
56 patients with unilateral distal radius fracture were randomized to fixation using volar locking plates or to control treatment with either closed reduction and casting for 6 weeks, K-wire fixation and casting for 6 weeks, or external fixation, with/without supplemental K-wires. Control intervention was left to the discretion of the treating physician. Results at 3 Please login to view the rest of this report. Please login to view the rest of this report.
Funding: Not Reported
Conflicts: None disclosed
CONTENT IS LOCKED
Why was this study needed now?
Volar locking plates have emerged as a popular treatment method for distal radius fractures. One of the most important cited benefits associated with volar locked plating is the ability to allow immediate mobilization after surgery, while other operative and nonoperative treatment methods typically require a period of immobilization. The impact of mobilization versus immobilization on short-term outcomes has not been specifically focused on in previous literature.
What was the principal research question?
How do clinical, functional, and radiographical outcomes after 12 weeks compare between volar locked plating with immediate mobilization postoperatively and treatment, operative or nonoperative, followed by 6-week immobilization in the management of patients with distal radius fractures?
Population: 56 patients, over 18 years of age, with a unilateral distal radius fracture
Intervention: VLP group: Patients underwent fixation using either a fixed or variable volar locking plate (Synthes GmbH). After surgery, patients were allowed to mobilize the wrist as tolerated and began physiotherapy.
Comparison: Control group: Patients were treated using either closed reduction and casting for 6 weeks, K-wire fixation and casting for 6 weeks, or external fixation, with/without supplemental K-wires. Hardware was removed after 6 weeks, and patients began physiotherapy.
Outcomes: The range of motion was assessed during the clinical assessment. The Disability of Arm, Shoulder, and Hand (DASH) questionnaire and the Patient-Rated Wrist Evaluation (PRWE) were used to assess function. Radiographic evaluation was performed for the volar slope, radial inclination, and ulnar variance.
Methods: RCT
Time: Follow-up was performed at 12 weeks after treatment.
What were the important findings?
What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.