title: A randomized comparison of volar plate and external fixation for intra-articular distal radius fractures.
abstract: OBJECTIVE
  To compare surgical outcomes of volar locking plates (VP) and external fixation (EF) (with or without intra-focal fixation) for AO-type C2 and C3 fractures of the distal radius.
  
  
  METHODS
  From an initial group of 92 patients with AO-type C2 and C3 distal radius fractures who were enrolled in a prospective, randomized study comparing volar plate fixation with external fixation (with or without intra-focal fixation), 74 patients were studied. The researchers evaluated functional assessments (wrist range of motion, grip strength, and Michigan Hand Questionnaire) at each patient visit and measured radiographic assessment (radial inclination, volar tilt, ulnar variance, and articular congruity) at 12 months.
  
  
  RESULTS
  The grip strength of the VP group was significantly greater than that of the EF group at 3 and 6 months. The range of motion was significantly greater in the VP group than in the EF group at 3 months. There were no significant differences in the range of motion and grip strength between the 2 groups at 12 months. The Michigan Hand Questionnaire score was higher in the VP group than in the EF group at 3 months but was same at 12 months. There was no significant difference between groups with respect to volar tilt or radial inclination. The VP group showed superior radiologic outcomes in terms of the ulnar variance. One patient in the VP group and 3 in the EF group had an intra-articular stepoff deformity greater than 2 mm. This difference did not reach statistical significance.
  
  
  CONCLUSIONS
  These results for functional recovery after distal radius surgery offer insight into treatment decisions and interpretations of treatment outcomes for patients with comminuted intra-articular distal radius fractures.
authors.affiliation: Department of Orthopedic Surgery, Gil Medical Center, Gachon University School of Medicine, Incheon; Department of Orthopedic Surgery, Kangwon National University Hospital, Chuncheon-si, Gangwon-do; Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Young Hak
authors.initials: YH
authors.lastname: Roh
authors.affiliation: Department of Orthopedic Surgery, Gil Medical Center, Gachon University School of Medicine, Incheon; Department of Orthopedic Surgery, Kangwon National University Hospital, Chuncheon-si, Gangwon-do; Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Beom Koo
authors.initials: BK
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Gil Medical Center, Gachon University School of Medicine, Incheon; Department of Orthopedic Surgery, Kangwon National University Hospital, Chuncheon-si, Gangwon-do; Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jong Ryoon
authors.initials: JR
authors.lastname: Baek
authors.affiliation: Department of Orthopedic Surgery, Gil Medical Center, Gachon University School of Medicine, Incheon; Department of Orthopedic Surgery, Kangwon National University Hospital, Chuncheon-si, Gangwon-do; Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea. Electronic address: bestknee@hotmail.com.
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Noh
authors.affiliation: Department of Orthopedic Surgery, Gil Medical Center, Gachon University School of Medicine, Incheon; Department of Orthopedic Surgery, Kangwon National University Hospital, Chuncheon-si, Gangwon-do; Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hyun Sik
authors.initials: HS
authors.lastname: Gong
authors.affiliation: Department of Orthopedic Surgery, Gil Medical Center, Gachon University School of Medicine, Incheon; Department of Orthopedic Surgery, Kangwon National University Hospital, Chuncheon-si, Gangwon-do; Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Goo Hyun
authors.initials: GH
authors.lastname: Baek
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D016267:External Fixators; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation*; D018460:Fractures, Comminuted / Q000601:surgery*; D018737:Hand Strength; D006801:Humans; D057072:Intra-Articular Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011885:Radius Fractures / Q000601:surgery*; D016059:Range of Motion, Articular; D020127:Recovery of Function
keywords: Distal radius fractures; complex articular fracture; external fixation; functional outcome; volar plating