Resumo

DURRANS, MJ; PRETORIUS, S; WELLS, M  e  IKRAM, A. Multicentre retrospective study comparing outcome of pinning and locking plates for treating distal radius fractures. SA orthop. j. [online]. 2013, vol.12, n.3, pp.01-10. ISSN 2309-8309.

BACKGROUND: Distal radial fractures are extremely common in the South African private and provincial sector, with intraarticular fractures making up a large portion of this group. Closed reduction is the cheapest method of treatment but the results are poor. Closed reduction and pinning is the next most cost-effective option with slightly better results. Plating of these fractures is another option. Volar locking plate systems have been shown to be the gold standard for fixation of these fractures with good to excellent objective and functional outcomes. The cost of these plating systems is, however, extremely expensive, and the need has arisen to identify patients that can be treated more affordably in the South African provincial healthcare system. AIM: To compare the functional outcomes of patients with intra-articular distal radius fractures treated with volar locking plates, and of those treated with closed reduction and pinning. METHODS: The multicentre retrospective study comprised two groups of patients: one group treated with volar locking plates; and the other treated with closed reduction and pinning. The functional outcome was our main objective, with objective outcomes and complications our secondary objectives. RESULTS: Statistically the results showed that the two groups did the same functionally even though objectively there were more complications in the closed reduction and pinning group. The only statistically significant finding was that the time to functional pain-free independence was 6 weeks earlier in the plate group than in the Kirschner wire (K-wire) group. CONCLUSIONS: Using these results we suggest that patients who have a good support system and/or can afford the time off work be treated with closed reduction and pinning. Those patients who have a poor support system and who cannot afford lengthy times away from work should be treated with volar locking plates. Further studies of this subject are needed.

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