Wrist function recovers more rapidly after volar locked plating than after external fixation but the outcomes are similar after 1 year

Figures & data

Figure 1. Flow chart of the patients.

Figure 2. Radiological measurements: axial shortening (a), dorsal angulation (b), and radial angulation (c).

Table 1. Clinical data

	Volar plating	External fixation
Mean age (range) in years	55 (20–69)	56 (21–69)
Female, n (%)	25 (76)	23 (77)
AO fracture type: A/C, n (%)	26 (79)/7 (21)	22 (73)/8 (27)
Dominant hand injury, n (%)	15 (45)	14 (47)
Retired, n (%)	9 (28)	9 (30)

Table 2. Patient-perceived results measured by the DASH and PRWE scores

	Volar plating	External fixation	p-value^a
DASH
3 months	9 (6–12)	27 (20–33)	< 0.001
6 months	6 (3–9)	14 (9–19)	0.008
12 months	7 (4–11)	11 (6–16)	0.1
PRWE
3 months	14 (8–20)	31 (23–39)	< 0.001
6 months	9 (5–14)	17 (11–22)	0.02
12 months	11 (6–16)	15 (9–21)	0.3

Values are presented as points (95% CI) corrected for baseline values. Higher scores indicate more disability.

^a Wilcoxon rank-sum test.

Table 3. Objective physical measurements (95% CI) expressed as a percentage of the uninjured side

	Volar plating	External fixation	p-value ^a
3 months
Grip strength	72 (64–80)	46 (37–55)	< 0.001
Extension	84 (78–90)	59 (49–69)	< 0.001
Flexion	81 (77–85)	71 (65–77)	0.009
Ulnar deviation	89 (81–97)	74 (63–86)	0.04
Radial deviation	89 (80–98)	75 (55–95)	0.2
Supination	95 (91–98)	76 (68–85)	< 0.001
Pronation	98 (96–100)	89 (84–94)	< 0.001
6 months
Grip strength	89 (83–95)	72 (65–78)	< 0.001
Extension	92 (86–97)	77 (68–84)	0.001
Flexion	88 (84–91)	83 (78–88)	0.1
Ulnar deviation	99 (92–106)	91 (79–103)	0.2
Radial deviation	103 (92–115)	89 (70–107)	0.2
Supination	98 (95–100)	88 (84–93)	< 0.001
Pronation	100 (100–100)	95 (92–99)	0.005
12 months
Grip strength	94 (86–102)	85 (79–91)	0.08
Extension	94 (90–98)	85 (77–93)	0.04
Flexion	89 (86–92)	83 (77–89)	0.08
Ulnar deviation	96 (87–105)	83 (72–93)	0.05
Radial deviation	97 (88–106)	89 (77–100)	0.3
Supination	99 (97–100)	89 (81–98)	0.02
Pronation	99 (98–100)	92 (86–99)	0.04

^a Student's t-test

Table 4. Mean (95% CI) radiological measurements presented as the difference from the uninjured wrist

	Volar plating	External fixation	p-value ^a
At injury
Axial shortening (mm)	4 (3-5)	4 (3-5)	0.9
Dorsal angulation (degrees)	41 (39–44)	43 (40–46)	0.4
Radial angulation (degrees)	11 (8–12)	9 (7–11)	0.5
Post reduction
Axial shortening (mm)	-2 (-2 to -1)	0 (0–1)	< 0.001
Dorsal angulation (degrees)	6 (5–8)	9 (6–12)	0.1
Radial angulation (degrees)	2 (1–3)	1 (0–2)	0.4
5 weeks postoperatively
Axial shortening (mm)	0 (-1–0)	1 (1–2)	< 0.001
Dorsal angulation (degrees)	7 (5–9)	11 (7–14)	0.07
Radial angulation (degrees)	2 (1–4)	2 (1–4)	0.9
12 months postoperatively
Axial shortening (mm)	0 (0–1)	2 (1–3)	< 0.001
Dorsal angulation (degrees)	7 (5–9)	11 (7–15)	0.05
Radial angulation (degrees)	2 (1–4)	3 (1–5)	0.5

^a Student's t-test.