Radiological outcome of Distal Radius fracture treated conservatively (MUA Plaster of Paris) Vs ORIF (Open Reduction and Internal Fixation): A comparative analysis.

Abstract

Objective: To compare the radiological outcomes of distal radius fractures treated conservatively (MUA + POP) versus operatively (ORIF) in adult patients, focusing on key radiographic parameters and early functional range of motion. Study Design: Prospective Comparative study. Setting: Ghurki Trust Teaching Hospital, Lahore. Period: December 15, 2024, and April 15. Methods: A total of 70 patients with Fernandez Type I distal radius fractures were enrolled and randomized into two equal groups: Group A (MUA + POP) and Group B (ORIF). Radiological parameters (radial height, radial inclination, volar tilt, and ulnar variance) and range of motion were assessed at 12 weeks post-treatment. Statistical analysis was performed using t-tests and chi-square tests, with a significance threshold of p < 0.05. Results: Group B (ORIF) demonstrated significantly better radiological alignment in terms of radial inclination (p = 0.015), radial height (p = 0.024), and ulnar variance (p = 0.019). Volar tilt showed improvement but was not statistically significant (p = 0.145). Despite superior alignment, ORIF was associated with a higher rate of articular step-off >2 mm (48.6% vs. 14.3%, p = 0.001). Range of motion outcomes (dorsiflexion, palmar flexion, and pronation) were statistically similar in both groups. Conclusion: Although ORIF offers superior radiographic restoration of anatomical parameters in distal radius fractures, functional outcomes in the short term, particularly range of motion, were comparable to conservative management. The increased incidence of articular incongruity in the ORIF group raises concerns about potential long-term implications. Thus, the choice of treatment should be individualized, balancing radiological goals with risks, patient profile, and resource availability.