A prospective, randomised multicenter controlled trial on the treatment of intra-articular distal radius fractures; open reduction and internal fixation with volair angle stable plating versus percutaneous reduction and fixation in combination with an external fixator

Fractures of the distal radius are a frequently seen common clinical problem al
over the world. Almast 4000 distal radius fractures were diagnosed in The
Netherlands in 2005. Because of an expected increase in eldery and the
incidence of osteoporosis, the number of fractures will increase. Almost 60 %
of the distal radius fractures are intra-articular fractures. Many different
treatment options are used.
To avoid late complications like posttraumatic arthritis it is important to
restore the intra-articular surface to its anatomic position, because deformity
leads to a decrease in functionality of the wrist. For the first period after
treatment it is important to choose a treatment option that will give the
patient quick recovery of wrist function. For the instable fracture types a
conservative treatment is not an option and those fractures should become
operative treatment.
At this moment, there is no consensus about the different options of treatment.

Closed reduction and fixation with external fixation shows some good results.
The development of the volar angle stable locking plates a new treatment option
can be used with less postoperative complications. Recovery of the intra
articular deformity will give the fracture elements more stability after
reposition.
These two treatment options have never been compared within a prospective,
randomised controlled trial.

The goal of this study will be to determine a functional benefit and an
increase in patient satisfaction after a period of one year of open reduction
and internal fixation (ORIF) by volar approach versus percutaneous reposition
and fixation with external fixation as a treatment of dislocated
intra-articular distal radius fractures

A multicenter prospective randomised controled trial. Intention to treat.

Group A will get a treatment with ORIF (open reposition and internal fixation)
and group B will get an external fixation

Both treatment options are already commonly used. Therefore the risks for the
patients will be minimal. After a regular follow-up of 6 months patients come
back for a final visit after one year. physical examination, two x-rays and
scoringsformulars will be filled in.