Treatment of unstable intraarticular fracture of distal radius: POP casting with external fixation

Objective: To compare radiological and functional outcome of external fixation and distraction with conservative Plaster of Paris (POP) cast for unstable intra-articular fractures of the distal radius.Methods: The study was conducted on 60 patients with unstable intra-articular fracture of distal radius who reported to emergency or outpatient Orthopaedic Surgery department of Benazir Bhutto Hospital, Rawalpindi, between March and August 2007. They were divided into two equal groups: Group A and Group B, treated by Plaster of Paris cast, and external fixation with distraction respectively. The functional outcome in terms of freedom from pain, range of movement, grip power and deformity, and the radiological outcome of radial length, incongruity and radio-ulnar joint position were analysed at three months follow-up using a 3-point scoring scale.Results: In Group A, 1 (3%) patient showed excellent result, 8 (27%) patients good results, 19 (63%) patients fair results and 2 (7%) patients poor result. In Group B, 14 (47%) patients showed excellent results, 11 (37%) patients good results, 4 (13%) patients fair results and 1 (3%) patient poor result. The outcome score of the Group B patients was significantly better compared to the Group A patients (p value 0.05).Conclusion: External fixation has definite advantages over conventional Plaster of Paris cast in the treatment of unstable intra-articular fractures of distal radius