Comparative functional outcomes of distal radius fractures treated with Joshi’s external stabilization system versus volar locking plate fixation: a prospective cohort study

Authors

  • Sagar V. Bhanushali Department of Orthopaedics, Vedantaa Institute of Medical Sciences, Palghar, Maharashtra, India
  • Padmakar Shinde Department of Orthopaedics, Vedantaa Institute of Medical Sciences, Palghar, Maharashtra, India
  • Rajesh Patil Department of Orthopaedics, Vedantaa Institute of Medical Sciences, Palghar, Maharashtra, India
  • Saurabh Ponde Department of Orthopaedics, Vedantaa Institute of Medical Sciences, Palghar, Maharashtra, India
  • Abhilash Pohokar Department of Orthopaedics, Vedantaa Institute of Medical Sciences, Palghar, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20263907

Keywords:

Volar plating, DASH score, Distal radius fracture, JESS, Wrist outcomes

Abstract

Background: Distal radius fractures are among the most common orthopedic injuries. Joshi’s external stabilization system (JESS) and volar locking plate fixation are widely used surgical options with differing biomechanical principles.

Methods: A prospective cohort study of 94 patients with distal radius fractures was conducted. Patients underwent either JESS or volar locking plate fixation. Functional outcomes were assessed using DASH scores at 6 and 12 months and modified Mayo wrist score (MMWS) at 12 months.

Results: Volar plating demonstrated superior functional outcomes, with significantly better early recovery and consistently improved scores at final follow-up. Patients treated with volar plating achieved better range of motion and grip strength. The JESS group showed gradual improvement over time but did not match the overall functional outcomes of the plating group. Pin tract infections were more common in the JESS group, whereas hardware-related complications were observed in the plating group.

Conclusions: Volar locking plate fixation provides superior functional outcomes in distal radius fractures, both in early recovery and at final follow-up. While JESS remains a viable option in selected cases, volar plating should be preferred where feasible.

References

Kapoor H, Agarwal A, Dhaon BK. Displaced intra-articular fractures of distal radius. Injury. 2000.

Arora R, Lutz M, Hennerbichler A, Krappinger D, Espen D, Gabl M. Complications following internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthoped Trauma. 2007;21(5):316-22.

Rozental TD, Blazar PE, Franko OI, Chacko AT, Earp BE, Day CS. Functional outcomes for unstable distal radial fractures treated with open reduction and internal fixation or closed reduction and percutaneous fixation: a prospective randomized trial. JBJS. 2009;91(8):1837-46.

Wei DH, et al. Comparative fixation methods. J Bone Joint Surg. 2009.

Egol KA, Walsh M, Romo-Cardoso S, Dorsky S, Paksima N. Distal radial fractures in the elderly: operative compared with nonoperative treatment. JBJS. 2010;92(9):1851-7.

Walenkamp MM, et al. Meta-analysis of fixation techniques. Injury. 2013.

Dubey A, Kumaran SS. Functional outcomes of JESS fixator application in fractures of distal end radius: a prospective study. Int J Orthop Sci. 2024;10(1):3522.

Joo M, Kang H, Yu HK, Lee JS. Outcomes of primary volar locking plate fixation of open distal radius fractures. J Hand Surg Asian Pac. 2022;27(1):1-7.

Dixit A, Harish S, DK D, J D. To compare the outcome of closed reduction external fixation versus open reduction internal fixation with volar locking plate in intra-articular distal radius fracture. Int J Orthop Sci. 2023;9(1):3309.

Garg UK, Sharma VP, Jain UK. Long-term functional outcome in fractures of the lower end radius in young adults treated by static external fixator. J Bone Joint Dis. 2017;32(3):29-32.

Chauhan LS. Functional outcome in fracture in lower end radius in patients treated with Joshi External Stabilizing System (JESS fixator). Int J Sci Res. 2023;10(4).

Tailor H, Jasoliya V. Functional outcome of intra-articular lower end radius fractures treated by JESS fixator with K-wires versus plating: A comparative study. 2019.

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Published

2026-10-28

How to Cite

Bhanushali, S. V., Shinde, P., Patil, R., Ponde, S., & Pohokar, A. (2026). Comparative functional outcomes of distal radius fractures treated with Joshi’s external stabilization system versus volar locking plate fixation: a prospective cohort study. International Journal of Research in Orthopaedics, 12(6), 1759–1761. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20263907

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Original Research Articles