Clinical results of minimally invasive plate osteosynthesis versus conventional approach in volar locking plate fixation for closed distal radius fractures under wide-awake local anesthesia.

Study Summary

66 patients with isolated closed distal radius fractures were randomized to receive minimally invasive plate osteosynthesis (MIPO) or conventional volar locking plate fixation using wide-awake local anaesthesia no tourniquet (WALANT). The primary outcome was postoperative day 1 (POD1) pain measured using the visual analogue scale (VAS). Secondary outcomes included morphine consumption, Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores, grip and pinch strength, range of motion (ROM), operative time, cosmetic outcomes, radiographic parameters, and complications. Outcomes were assessed for up to 6 months. Overall, the results of the study revealed that MIPO provided statistically lower POD1 pain scores than conventional fixation, although the difference did not reach the minimal clinically important difference (MCID). Functional recovery, radiographic outcomes, and complication rates were comparable, while MIPO produced smaller incisions and better cosmetic scores but required substantially more fluoroscopic exposure. These findings suggested that MIPO under WALANT was an alternative to conventional fixation, particularly when cosmetic outcomes were a priority.