Evaluation of functional results of different treatment modalities in Intra- articular fracture of distal end of radius in adults at a tertiary care hospital in Eastern India

Abstract

Fractures of the distal radius (DRF) are the most common orthopedic injuries: one out of every six fractures presented at emergency department is a distal radius fracture. Almost two-thirds of these fractures are displaced and need to be reduced. Epidemiological studies point out that the age rate curve is bimodal and that the highest incidences are found in children and the elderly. DRF constitute 14% of all extremity injuries. They occur as a result of high or low energy trauma resulting in significant injury and impairment of function of the upper extremity. Randomized controlled trial has been attempted to scrutinize the best method for treating DRF, ranging from methods of conservative treatment to advanced strategies of plate osteo-synthesis.124 Patients with 126 intra-articular distal radius fractures were studied, who met with predefined inclusion and exclusion criteria at Department of Orthopaedics, Kalinga Institute of Medical Sciences, Bhubaneswar from 1st October 2017 to 30th September 2019. They underwent different treatment interventions. The cases were followed for 12 months at regular intervals for serial clinical & radiological evaluation. Functional grading and pain scoring was done for different treatment modalities. Radiological grading was made based on union/ non-union of fracture.Majority with wrist fracture were of age 20-40 years followed by the age group 61-80 years. Grip strength was reported better in surgical group(79.2%). Mode of treatment is statistically significant with Palmar flexion (p = 0.015), Supination (p=0.025) and Pronation (p<0.001) of wrist post surgical treatment. Plating group experience significantl less pain (p=0.012). Mean function score for surgical group is 19.8.The impetus for the inclination towards treatment of wrist fracture by surgery, mainly plating method, stands multifactorial and might bring better outcomes in terms of range and degree of movement, expedited recovery, lower chances of malunion and in a way, better prognosis and quality of life in case of DRF.