title: Comparison of treatment of unstable intra articular fractures of distal radius with locking plate versus non-locking plate fixation.
abstract: BACKGROUND
  Unstable intra articular fractures of distal radius are frequently being managed with open reduction and internal fixation. Of late in some biomechanical studies locking plates have been shown to be better in terms of maintenance of radiological parameters in comparison to non-locking plates. We conducted this study to know whether this biomechanical superiority of locking plates is converted in to better clinical outcomes.
  
  
  METHODS
  A study was conducted in 60 patients (30 in each group) with unstable intra articular fractures of distal radius who were treated by open reduction and internal fixation with locking plates and non-locking plates. Patients were evaluated for radiological parameters (intra articular step off, radial height, radial tilt, volar tilt) and functional parameters (flexion, extension, radial deviation, ulnar deviation, pronation, supination grip strength) at two year follow up. Overall outcome was evaluated by scoring systems of Gartland and Werley and modified Green O' Brien.
  
  
  RESULTS
  The change in radiological parameters from immediate post op to latest at two year in locking plate group was not significant for radial height, radial tilt, volar tilt, but ulnar variance whereas in non-locking plate there was significant change in radial height, volar tilt, ulnar variance but no significant change in radial inclination. In clinical and functional outcome no significant difference was found at two year follow up.
  
  
  CONCLUSIONS
  Locking plates maintain the radiological parameters better than non-locking plates but functional outcome are same for both plates at two year after surgery.
authors.affiliation: Senior Resident, Central Institute of Orthopaedics, V.M.M.C. & Safdarjung Hospital, New Delhi, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Professor, Central Institute of Orthopaedics, V.M.M.C. & Safdarjung Hospital, New Delhi, India.
authors.forename: R K
authors.initials: RK
authors.lastname: Chopra
authors.affiliation: Senior Resident, Central Institute of Orthopaedics, V.M.M.C. & Safdarjung Hospital, New Delhi, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Sehrawat
authors.affiliation: Senior Resident, Department of Orthopaedics, M.A.M.C. & Lok Nayak Jai Prakash Hospital, New Delhi, India.
authors.forename: Akshay
authors.initials: A
authors.lastname: Lakra
keywords: Distal radius; Locking; Non-locking plate; Unstable intra-articular