Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Orthopaedics

Background: There is no consensus on the optimal operative treatment of distal radius fractures as every technique is associated with advantages and shortcomings. Objective: This study aim to compare functional and radiological outcome of below elbow cast immobilization versus external fixator as a supplement to k-wires in fixation of type A and type C1 with no volar metaphyseal comminution in AO/OTA Classification. Patients and methods: This study included 30 patients (15 males and 15 females). With an average age of 36 years who presented at Emergency Hospital of Kasr-ALAiny. Patients were allocated randomly into 2 groups(block randomization(sealed envelops)) according to fixation methods; Group (A) 15 patients: were fixed with K-wires and below elbow cast Group (B) 15 patients: were fixed with K-wires and external fixator. All the fractures were evaluated both functionally using quick DASH and modified Mayo wrist score and radiologically by measuring radial height, radial inclination and volar tilt. The follow up period ranged from 4 to 6 months with mean value 6 months. Results: Radiological assessment: After 3 months post-operative1-Radial height:is significantly higher with group (B) than group (A).(p value 0.003),2- Radial inclination : is statistically insignificant between the two groups.(p value 0.116),3- Volar tilt:is significantly higher with group (B) than group (A).(p value P=0.017) Functional assessment: After 6 months post-operative1. Modified mayo wrist score:, is statistically insignificant between the two groups(p value 0.118). 2. Quick DASH score: isstatistically insignificant between the two groups.(p value 0.059) 3. Supination: is statistically insignificant between the two groups.(p value 0.071) 4. pronation : is significantly higherwith group (B) than group (A).(p value 0.050) Complications:In group A : two patients had superficial pin tract infection(13.3%), In group B:one patient had CRPS(6.6%)

Issued also as CD