title: Wrist function recovers more rapidly after volar locked plating than after external fixation but the outcomes are similar after 1 year.
abstract: OBJECTIVE
  Promising results have been reported after volar locked plating of unstable dorsally displaced distal radius fractures. We investigated whether volar locked plating results in better patient-perceived, objective functional and radiographic outcomes compared to the less invasive external fixation.
  
  
  METHODS
  63 patients under 70 years of age, with an unstable extra-articular or non-comminuted intra-articular dorsally displaced distal radius fracture, were randomized to volar locked plating (n = 33) or bridging external fixation. Patient-perceived outcome was assessed with the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire and the Patient-Rated Wrist Evaluation (PRWE) questionnaire.
  
  
  RESULTS
  At 3 and 6 months, the volar plate group had better DASH and PRWE scores but at 12 months the scores were similar. Objective function, measured as grip strength and range of movement, was superior in the volar plate group but the differences diminished and were small at 12 months. Axial length and volar tilt were retained slightly better in the volar plate group.
  
  
  CONCLUSIONS
  Volar plate fixation is more advantageous than external fixation, in the early rehabilitation period.
authors.affiliation: Division of Orthopaedics, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden. maria.wilcke@ds.se
authors.forename: Maria K T
authors.initials: MK
authors.lastname: Wilcke
authors.forename: Hassan
authors.initials: H
authors.lastname: Abbaszadegan
authors.forename: Per Y
authors.initials: PY
authors.lastname: Adolphson
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D018460:Fractures, Comminuted / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011885:Radius Fractures / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014955:Wrist Joint / Q000503:physiopathology*