Fragment-specific fixation for complex intra-articular fractures of the distal radius: results of a prospective single-centre trial

The goal was to evaluate the efficacy of 2.4 mm column-specific plating for intra-articular distal radius fractures. In total, 105 patients with AO type C distal radius fractures were operated on using the locking distal radius system, Synthes. Follow-up assessments including clinical (wrist and forearm range of motion, grip strength), radiological (articular step, radial length and inclination, volar tilt, and ulnar variance), and functional scores (Disabilities of the Arm, Shoulder, and Hand; Patient Rated Wrist Evaluation) were made at regular intervals until 1 year. Union was obtained in all patients. Articular surface was anatomically reconstructed in 74 patients (70.5%). Clinical and functional evaluation showed significant continuous improvements over the first year. C1 fractures had a better chance of anatomical reduction compared with C2 and C3 fractures. Fracture type, quality of reduction, and presence of degenerative changes did not show a significant effect on functional outcome scores. Column-specific fixation of the distal radius can achieve satisfactory results in complex intra-articular fractures.

[1]  J. Jupiter,et al.  Operative management of distal radial fractures with 2.4-millimeter locking plates. A multicenter prospective case series. , 2009, The Journal of bone and joint surgery. American volume.

[2]  J. Jupiter,et al.  Management of distal radial fractures. , 2007, The Journal of bone and joint surgery. American volume.

[3]  R. Seshadri,et al.  The outcome of intra-articular distal radius fractures treated with fragment-specific fixation. , 2006, The Journal of hand surgery.

[4]  J. Crisco,et al.  The volar extension of the lunate facet of the distal radius: a quantitative anatomic study. , 2006, The Journal of hand surgery.

[5]  G. Harris,et al.  The influence of three-dimensional computed tomography reconstructions on the characterization and treatment of distal radial fractures. , 2006, The Journal of bone and joint surgery. American volume.

[6]  T. Turner,et al.  Effects of Implant Material and Plate Design on Tendon Function and Morphology , 2006, Clinical orthopaedics and related research.

[7]  A. Bryant,et al.  Volar fixed-angle plating of distal radius extension fractures: influence of plate position on secondary loss of reduction--a biomechanic study in a cadaveric model. , 2006, The Journal of hand surgery.

[8]  B. Gabbe,et al.  Does the disabilities of the arm, shoulder and hand (DASH) scoring system only measure disability due to injuries to the upper limb? , 2006, The Journal of bone and joint surgery. British volume.

[9]  S. Trigg.  Functional Outcome and Complications After Volar Plating for Dorsally Displaced, Unstable Fractures of the Distal Radius , 2006 .

[10]  S. D. Dodds,et al.  A biomechanical comparison of fragment-specific fixation and augmented external fixation for intra-articular distal radius fractures. , 2002, The Journal of hand surgery.

[11]  J. Orbay,et al.  Volar fixation for dorsally displaced fractures of the distal radius: a preliminary report. , 2002, The Journal of hand surgery.

[12]  P. Regazzoni,et al.  The double plating technique for distal radius fractures. , 2000, Techniques in hand & upper extremity surgery.

[13]  J. Macdermid,et al.  Patient rating of wrist pain and disability: a reliable and valid measurement tool. , 1998, Journal of orthopaedic trauma.

[14]  Robert W. Bucholz,et al.  The Comprehensive Classification of Fractures of Long Bones. , 1991 .

[15]  T. Davis.  Intra-articular fractures of the distal end of the radius in young adults. , 1987, The Journal of bone and joint surgery. American volume.