title: Randomized clinical trial on percutaneous minimally invasive osteosynthesis of fractures of the distal extremity of the radius.
abstract: OBJECTIVE
  the purpose of this study was to compare the postoperative radiological and clinical outcomes with minimally invasive percutaneous osteosynthesis using three implants: volar locking plate, intramedullary nail system and nonbridging external fixator for distal radius fractures.
  
  
  METHODS
  forty-eight patients (A group, 16; B group 16; C group 16) underwent minimally invasive percutaneous osteosynthesis of reductible and unstable displaced (Type IIB by Rayhack Classification) distal radius fractures. In B group intramedullary nail system was used, in A group the patients were treated with volar locking plate and in C group the patients were treated by nonbridging external fixator from January 2011 to December 2012. The mean follow-up period was 12 months. Radiologic parameters, range of motion, grip strength, and disability of the arm, shoulder, and hand score were evaluated at each examination (3rd and 6th week, and 12th months). The visual analog scale of wrist pain and complications were assessed at the final follow-up.
  
  
  RESULTS
  the groups did not differ significantly in radiological outcomes after 12 months, but the clinical results, VAS scale and dash score in group A (volar locking plate) and B (nail intramedullary) were statistically significantly better than that of C group (nonbridging external fixator). One patient underwent an osteosynthesis with nail intramedullary and another with external fixator (C group) developed persistent pain near the site of the superficial radial nerve because of the distal's screw and pins, respectively.
  
  
  CONCLUSIONS
  in clinical parameters, significant differences in outcomes were found between groups A and B after six weeks versus C group.
authors.affiliation: Ortopedia e Traumatologia, Faculdade de Medicina do ABC, Santo André, SP, Brazil.
authors.forename: Marcio Aurélio
authors.initials: MA
authors.lastname: Aita
authors.affiliation: Ortopedia e Traumatologia, Faculdade de Medicina do ABC, Santo André, SP, Brazil.
authors.forename: Carlos Henrique
authors.initials: CH
authors.lastname: Vieira Ferreira
authors.affiliation: Ortopedia e Traumatologia, Faculdade de Medicina do ABC, Santo André, SP, Brazil.
authors.forename: Daniel
authors.initials: D
authors.lastname: Schneider Ibanez
authors.affiliation: Ortopedia e Traumatologia, Faculdade de Medicina do ABC, Santo André, SP, Brazil.
authors.forename: Rafael
authors.initials: R
authors.lastname: Saraiva Marquez
authors.affiliation: Ortopedia e Traumatologia, Faculdade de Medicina do ABC, Santo André, SP, Brazil.
authors.forename: Douglas
authors.initials: D
authors.lastname: Hideki Ikeuti
authors.affiliation: Ortopedia e Traumatologia, Faculdade de Medicina do ABC, Santo André, SP, Brazil.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Toledo Mota
authors.affiliation: Ortopedia e Traumatologia, Faculdade de Medicina do ABC, Santo André, SP, Brazil.
authors.forename: Marcos Vinicius
authors.initials: MV
authors.lastname: Credidio
authors.affiliation: Ortopedia e Traumatologia, Faculdade de Medicina do ABC, Santo André, SP, Brazil.
authors.forename: Edison
authors.initials: E
authors.lastname: Noboru Fujiki
keywords: Bone plate; Fractures of the radius; Internal fracture fixation