Summary
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.
