title: Fragment-Specific Fixation Versus Volar Locking Plates in Primarily Nonreducible or Secondarily Redisplaced Distal Radius Fractures: A Randomized Controlled Study.
abstract: OBJECTIVE
  To compare the patient-reported, clinical, and radiographic outcome of 2 methods of internal fixation in distal radius fractures.
  
  
  METHODS
  Fifty patients, mean age 56 years (range, 21-69 years) with primarily nonreducible or secondarily redisplaced distal radius fractures were randomized to open reduction internal fixation using volar locking plates (n = 25) or fragment-specific fixation (n = 25). The patients were assessed on grip strength, range of motion, patient-reported outcome (Quick Disabilities of the Arm, Shoulder, and Hand), pain (visual analog scale), health-related quality of life (Short Form-12 [SF-12]), and radiographic evaluation. Grip strength at 12 months was the primary outcome measure.
  
  
  RESULTS
  At 12 months, no difference was found in grip strength, which was 90% of the uninjured side in the volar plate group and 87% in the fragment-specific fixation group. No differences were found in range of motion and the median Quick Disabilities of the Arm, Shoulder, and Hand score was 5 in both groups. The overall complication rate was significant, 21% in the volar locking plate group, compared with 52% in the fragment-specific group.
  
  
  CONCLUSIONS
  In treatment of primarily nonreducible or secondarily redisplaced distal radius fractures, volar locking plates and fragment-specific fixation both achieve good and similar patient-reported outcomes, although more complications were recorded in the fragment-specific group.
  
  
  METHODS
  Therapeutic II.
authors.affiliation: Department of Orthopedics, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden. Electronic address: marcus.landgren@med.lu.se.
authors.forename: Marcus
authors.initials: M
authors.lastname: Landgren
authors.affiliation: Department of Orthopedics, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden.
authors.forename: Antonio
authors.initials: A
authors.lastname: Abramo
authors.affiliation: Department of Medical Imaging and Physiology, Lund University and Skåne University Hospital, Lund, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Geijer
authors.affiliation: Department of Orthopedics, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden.
authors.forename: Philippe
authors.initials: P
authors.lastname: Kopylov
authors.affiliation: Department of Orthopedics, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Tägil
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011885:Radius Fractures / Q000601:surgery*; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000601:surgery*; D055815:Young Adult
keywords: Distal radius fracture; fragment-specific fixation; open reduction internal fixation; randomized trial; volar locking plate