title: Outcomes and complications of fractures of distal radius (AO type B and C): volar plating versus nonoperative treatment.
abstract: OBJECTIVE
  Management of AO type B and C fractures of the distal radius is controversial. This study compares outcomes and complications of AO type B and C fractures of the distal radius treated with volar locked plating and nonoperative methods.
  
  
  METHODS
  Sixty-four patients with fractures of the distal radius (AO type B and C) were included in this study, according to inclusion criteria, and were allocated to the volar plating group or nonoperative group by alternate randomization: 32 patients with odd numbers went into the nonoperative group and the other 32 with even numbers went into the volar plating group. Patients in the nonoperative group were managed with closed reduction of the fracture and plaster cast application under an image intensifier. Those in the volar plating group were managed by open reduction and fixation with a volar locked plate. Preoperative and postoperative serial clinico-radiological follow-up was done. The range of movement, grip strength, functional outcome scores and radiological parameters were compared. Student's t-test was used for statistical analysis with significance at p < 0.05.
  
  
  RESULTS
  Range of movement and functional scores were significantly (p < 0.001) better in the volar plating group, but the difference in ulnar variance and radial and ulnar deviation was insignificant as compared to the nonoperative group. At 24 months follow-up, the nonoperative group had significantly more cases with malunion, articular incongruity and osteoarthritis.
  
  
  CONCLUSIONS
  In cases of AO type B or C fractures of the distal radius, volar locked plating provides anatomical stable fixation and early mobilization with better clinico-radiological outcome as compared to conservative treatment.
authors.affiliation: Department of Orthopedics, Institute of Medical Sciences, BHU, Varanasi, India.
authors.forename: Himanshu
authors.initials: H
authors.lastname: Sharma
authors.forename: Ghanshyam Narayan
authors.initials: GN
authors.lastname: Khare
authors.forename: Saurabh
authors.initials: S
authors.lastname: Singh
authors.forename: Arun Govindraj
authors.initials: AG
authors.lastname: Ramaswamy
authors.forename: Vinay
authors.initials: V
authors.lastname: Kumaraswamy
authors.forename: Ashutosh Kumar
authors.initials: AK
authors.lastname: Singh
mesh_terms: D001860:Bone Plates; D002370:Casts, Surgical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D011446:Prospective Studies; D011885:Radius Fractures / Q000145:classification / Q000150:complications* / Q000628:therapy*; D016896:Treatment Outcome