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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 6, 829-836.
doi: 10.1302/0301-620X.87B6.15539  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Indirect reduction and percutaneous fixation versus open reduction and internal fixation for displaced intra-articular fractures of the distal radius

A RANDOMISED, CONTROLLED TRIAL

H. J. Kreder, MD, Associate Professor1; D. P. Hanel, MD, Professor2; J. Agel, MA, Research Coordinator2; M. McKee, MD, Associate Professor3; E. H. Schemitsch, MD, MPH, FRCSC, Professor3; T. E. Trumble, MD, Professor2; and D. Stephen, MD, Assistant Professor1

1 Division of Orthopaedics, University of Toronto, Sunnybrook & Women’s College, Health Sciences Centre, MG365, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.
2 Department of Orthopaedics, Harborview Medical Center, ZA-48, 325-9th Avenue, Seattle, Washington 98104, USA.
3 Division of Orthopaedics, University of Toronto, St. Michael’s Hospital, 55 Queen Street, Suite 800, Toronto, Ontario M5C 1R6, Canada.

Correspondence should be sent to Dr J. Agel; e-mail: agelx001{at}umn.edu

A total of 179 adult patients with displaced intra-articular fractures of the distal radius was randomised to receive indirect percutaneous reduction and external fixation (n = 88) or open reduction and internal fixation (n = 91). Patients were followed up for two years. During the first year the upper limb musculoskeletal function assessment score, the SF-36 bodily pain sub-scale score, the overall Jebsen score, pinch strength and grip strength improved significantly in all patients. There was no statistically significant difference in the radiological restoration of anatomical features or the range of movement between the groups.

During the period of two years, patients who underwent indirect reduction and percutaneous fixation had a more rapid return of function and a better functional outcome than those who underwent open reduction and internal fixation, provided that the intra-articular step and gap deformity were minimised.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General