Outcomes of Pin and Plaster Versus Locking Plate in Distal Radius Intraarticular Fractures

Background: Distal radius fractures are among the most prevalent fractures predictive of probable occurrence of other osteoporotic fractures. They are treated via a variety of methods, but the best treatment has not been defined yet. Objectives: This study was performed to compare the results of open reduction and internal fixation with locking plates versus the pin and plaster method. Materials and Methods: In this prospective study, ۱۱۴ patients aged ۴۰ to ۶۰ years with Fernandez type III fracture referring to Imam-Reza and Mehr hospitals of Mashhad from ۲۰۰۹ to ۲۰۱۱, were selected randomly; after obtaining informed consent, they were treated with pin and plaster fixation (n = ۵۷) or internal fixation with the volar locking plate (n = ۵۷). They were compared at the one year follow up. Demographic features and standard radiographic indices were recorded and MAYO, DASH and SF - ۳۶ tests were performed. Data was analyzed by SPSS software version ۱۳, with descriptive indices, Mann-Whitney and Chi-square tests. Results: SF-۳۶ test demonstrated a better general health (P < ۰.۰۰۱), mental health (P = ۰.۰۰۶), physical functioning (P < ۰.۰۰۱), social functioning (P < ۰.۰۰۱) and energy/fatigue (P < ۰.۰۰۱) in LCP group. However, pain (P = ۰.۶۴۷) was not significantly different between the groups. Physical limitation (P < ۰.۰۰۱) and emotional limitation (P < ۰.۰۰۱) were greater in the pin and plaster group. Also, in the LCP group mean MAYO score (P < ۰.۰۰۱) was more than pin and plaster group. Mean DASH score was not different between the groups (P = ۰.۲۱۸). The rate of acceptable results of radiographic indices (P < ۰.۰۰۱), grip strength (P < ۰.۰۰۱) and range of motion in supination-pronation (P < ۰.۰۰۱) in LCP method were better than the pin and plaster method. Conclusions: In treatment of intra-articular distal radius fractures in middle-aged patients internal fixation with locking plates may be prefered to pin and plaster as the treatment of choice.