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Randomized Clinical Trial for Surgical Treatment - Distal Radius Fractures - MIPO
Marcio A. Aita, MD; Eduardo Gasparotti, Resident; Alvaro Baik Cho, Prof, Dr; Rafael Saleme, Resident; Faculdade de Medicina do ABC
Objective: To compare the clinical and functional results of patients with diagnosis of unstable reducible the distal radius fractures underwent surgery for minimally invasive technique using three different implants:Stability angle volar plate "percutaneous", blocked intramedullary nail and External Fixator "non-bridge" hybrid.Method: 30 patients, all with a diagnosis of reducible and unstable the distal radius fractures and were divided into three groups, matched by randomization. Each group has 10 patients: group A - patients treated with volar plate "percutaneous", group B - treated with intramedullary nails and group C by external fixation hibrid and non-bridge. All patients were rehabilitated by the hand therapy, always using the same protocol. Patients were evaluated during the third week, sixth week and sixth month. Were calculated: the ROM, strength force (Jamar ®), DASH, VAS score and radiographic evaluation of fracture.Results: Patients in group B have the best clinical and functional results in the third and sixth week when compared to the other two groups and clinical and functional results similar to the group A in the sixth month of follow-up post-op, both superior to the results presented by patients in group C. The complication rate and 3.33%, one patient in group C had Sudeck's dystrophy and still following treatment with partial improvement of clinical symptoms. All patients kept the reduction of the fracture after the sixth month of surgery. Patients in group B returned to work before the patients in Group A that also came back before the group C. Conclusion: The minimally invasive technique for treating these fractures is a method effective, safe and fast, with a low index of complications.Both three implants maintain the reduction of the fracture until the sixth month of surgeryThe best clinical and functional results and earlier return to work are found in patients of group B
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