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Intraarticular distal radial fracturesExternal fixation versus open reduction with internal fixation
28 November 2006 (online)
Results of three randomized controlled trials, class of evidence II, comparing external fixation (EF) with open reduction and internal fixation (ORIF) for the treatment of intraarticular distal radial fractures described no consistent benefit of one treatment over another. Only grip strength was significantly better with EF compared with ORIF in two studies. There was a suggestion of fewer complications, more rapid return of function, and better functional outcome with EF, but these results were not consistent across studies. No statistically significant differences in rates of infection or reflex sympathetic dystrophy were seen between treatment groups. Larger, methodologically sound randomized controlled trials are needed to determine whether treatment with EF is indeed preferable to ORIF.