Volar Locking Plate Versus External Fixation for Distal Radius Fracture - a Longterm Follow up

Longterm Follow up for Displaced Distal Radius Fracture Randomized to Surgery With Volar Locking Plate or External Fixation

A 10-year follow up of a fusion of two earlier published randomized controlled trials. 203 patients with displaced distal radius fractures were randomized to surgery with a volar locking plate or external fixation.

Follow up includes PROMs (DASH, PRWE, EQ-5D), radiological assesment and objective tests by a hand occupational therapist (ROM, grip strength).

Previous Clinical trials registration for the original studies this long-term follow up is a continuation on: NCT00989222, NCT01034943, NCT01035359

Inclusion Criteria:

DS center

• acute unilateral dorsally displaced distal radius fracture with a axial shortening of at least 4 mm or a dorsal displacement of at least 20 degrees.
• Age 20-70

SÖS center

• Age 50-74 for women and 60-74 for men
• injury only after fall from a standing height
• wrist radiography of at least 20 degrees dorsal dislocation and/or at least 5 mm axial shortening
• good knowledge of written and spoken swedish
• fracture diagnosed within 72 hours from injury
• patient resident within the catchment area of SÖS center

Exclusion Criteria:

DS center:

• no previous fracture of either wrist
• ipsilateral acute fracture of the upper extremity
• medicated with warfarin
• unable to cooperate with follow-up (dementia, substance abuse, psychiatric illness, language problems)
• open fracture
• fracture that was not amenable by both methods (distal fragment to small or to comminuted)

SÖS center:

• former disability of either wrist
• other concomitant injuries
• rheumatoid arthritis or other severe joint disorder
• Dementia or pfeiffer score under 5 points
• drug abuse, alcohol abuse or psychiatric disorder
• dependency in activity of daily living
• medical condition contradicting general anesthesia