Comparison of 2-year clinical and radiological outcomes between volar plating and external fixation with additional K-wires for AO Type C distal radius fractures

Surgical treatment of distal intraarticular radius fractures remains controversial. Our aim was to compare the clinical and radiological outcomes between volar plating (VP) and external fixation (EF) for distal intraarticular radius fractures two years postoperatively. This retrospective study included 59 patients with 62 intraarticular AO Type C distal radius fractures. We distinguished two groups: patients treated with internal fixation (volar locking plate, VP group: 41 fractures), and patients treated with an external fixator and K-wires (EF group: 21 fractures). The clinical assessment included range of motion, grip strength, disability of the arm, shoulder, and hand (DASH), and visual analog scale scores. Radiological measurements comprised flexion and extension, radial volar tilt, inclination, height, shortening, and ulnar variance. Postoperative grip strength and flexion angles were better after VP (P = 0.004, P = 0.009), but there was no difference in DASH scores (P = 0.341). Radial inclination was significantly different compared to that of the uninjured hand after VP (P = 0.0183), but not EF (P = 0.11). VP and EF result in similar clinical and radiological outcomes after 2 years. Function is not restored to the functionality of the contralateral and noninjured hand.