title: Indirect reduction and percutaneous fixation versus open reduction and internal fixation for displaced intra-articular fractures of the distal radius: a randomised, controlled trial.
abstract: A total of 179 adult patients with displaced intra-articular fractures of the distal radius was randomised to receive indirect percutaneous reduction and external fixation (n = 88) or open reduction and internal fixation (n = 91). Patients were followed up for two years. During the first year the upper limb musculoskeletal function assessment score, the SF-36 bodily pain sub-scale score, the overall Jebsen score, pinch strength and grip strength improved significantly in all patients. There was no statistically significant difference in the radiological restoration of anatomical features or the range of movement between the groups. During the period of two years, patients who underwent indirect reduction and percutaneous fixation had a more rapid return of function and a better functional outcome than those who underwent open reduction and internal fixation, provided that the intra-articular step and gap deformity were minimised.
authors.affiliation: Division of Orthopaedics, University of Toronto, Ontario M4N 3M5, Canada.
authors.forename: H J
authors.initials: HJ
authors.lastname: Kreder
authors.forename: D P
authors.initials: DP
authors.lastname: Hanel
authors.forename: J
authors.initials: J
authors.lastname: Agel
authors.forename: M
authors.initials: M
authors.lastname: McKee
authors.forename: E H
authors.initials: EH
authors.lastname: Schemitsch
authors.forename: T E
authors.initials: TE
authors.lastname: Trumble
authors.forename: D
authors.initials: D
authors.lastname: Stephen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016267:External Fixators; D005592:Fracture Fixation / Q000379:methods*; D005593:Fracture Fixation, Internal / Q000379:methods; D018737:Hand Strength; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*