EFFICACY OF PLASTER CASTING VERSUS EXTERNAL FIXATION IN COMMINUTED DISTAL RADIUS FRACTURES
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Keywords:
External fixation, distal radius fractures, plaster cast.
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Abstract
Objective: To compare the outcomes of plaster casting and external fixation in comminuted distal radius
fractures.
Methodology: This prospective study was conducted at District Headquarter Teaching Hospital and
Khalifa Gul Nawaz Teaching Hospital Bannu from February 2009 to September 2010. A total of 30 adult
patients having comminuted distal radius fractures were included in this study. They were classified
according to AO/ASIF-Classification. The patients were randomized to plaster casting and external fixation
by lottery method. Follow-up of each case was done for a total duration of 12 weeks. Radiographic
assessment and clinical evaluation was conducted during each visit. Any complications arising during this
period were recorded. The outcomes were assessed at the end of 12 weeks. For grading the results, Green
& OꞌBrien clinical scoring system was used.
Results: Out of 30 patients, 15 were treated with plaster casting and 15 with external fixation. The mean
age of patients in plaster casting group was 49.80 years + 16.05 SD and in external fixation group 51.47
years + 15.01 SD. According to AO-Classification, there were 8 type- A, 10 type- B and 12 type- C
fractures. Radiographic evaluation at 12 weeks in plaster casting group showed mean values of volar tilt
2.8667 º, radial height 6.0000 mm, radial inclination 14.2000 º and articular step-off 1.5200 mm. In the
external fixation group, mean value of volar tilt was 5.7333 º, radial height 8.2000 mm, radial inclination
18.8000 º and articular step-off 1.0467 mm. Clinical evaluation based on Green & O'Brien scoring system
showed 4 excellent, 3 good, 4 fair and 4 poor results in plaster casting group and 5 excellent, 6 good, 2
fair and 2 poor results in external fixation group.
Conclusion: External fixation is an acceptable surgical solution for the treatment of comminuted distal
radius fractures as compared to cast immobilization.
fractures.
Methodology: This prospective study was conducted at District Headquarter Teaching Hospital and
Khalifa Gul Nawaz Teaching Hospital Bannu from February 2009 to September 2010. A total of 30 adult
patients having comminuted distal radius fractures were included in this study. They were classified
according to AO/ASIF-Classification. The patients were randomized to plaster casting and external fixation
by lottery method. Follow-up of each case was done for a total duration of 12 weeks. Radiographic
assessment and clinical evaluation was conducted during each visit. Any complications arising during this
period were recorded. The outcomes were assessed at the end of 12 weeks. For grading the results, Green
& OꞌBrien clinical scoring system was used.
Results: Out of 30 patients, 15 were treated with plaster casting and 15 with external fixation. The mean
age of patients in plaster casting group was 49.80 years + 16.05 SD and in external fixation group 51.47
years + 15.01 SD. According to AO-Classification, there were 8 type- A, 10 type- B and 12 type- C
fractures. Radiographic evaluation at 12 weeks in plaster casting group showed mean values of volar tilt
2.8667 º, radial height 6.0000 mm, radial inclination 14.2000 º and articular step-off 1.5200 mm. In the
external fixation group, mean value of volar tilt was 5.7333 º, radial height 8.2000 mm, radial inclination
18.8000 º and articular step-off 1.0467 mm. Clinical evaluation based on Green & O'Brien scoring system
showed 4 excellent, 3 good, 4 fair and 4 poor results in plaster casting group and 5 excellent, 6 good, 2
fair and 2 poor results in external fixation group.
Conclusion: External fixation is an acceptable surgical solution for the treatment of comminuted distal
radius fractures as compared to cast immobilization.
Article Details
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1.
. I. EFFICACY OF PLASTER CASTING VERSUS EXTERNAL FIXATION IN COMMINUTED DISTAL RADIUS FRACTURES. J Postgrad Med Inst [Internet]. 2012 Jun. 29 [cited 2024 Apr. 25];26(3). Available from: https://jpmi.org.pk/index.php/jpmi/article/view/1306
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