J Wrist Surg 2021; 10(03): 229-233
DOI: 10.1055/s-0040-1722573
Scientific Article

Early Retrieval of Spanning Plates Used for Fixation of Complex Fractures of the Distal Radius

1   Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
,
Jacob E. Tulipan
2   Department of Hand and Wrist Surgery, Rothman Orthopaedic Institute, Philadelphia, Pennsylvania
,
Richard M. McEntee
1   Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
,
Pedro K. Beredjiklian
2   Department of Hand and Wrist Surgery, Rothman Orthopaedic Institute, Philadelphia, Pennsylvania
› Author Affiliations
Funding None.

Abstract

Background Spanning plates are being increasingly used for the treatment of complex fractures of the distal radius. The traditional recommendation is to leave the hardware in place for at least 12 weeks.

Questions/Purpose This study assesses the comparative outcomes of spanning plates removed at or before 10 weeks. We hypothesized that acceptable healing and functional outcomes can be achieved with earlier hardware removal to allow for earlier range of motion, rehabilitation, and return to function.

Patients and Methods All patients treated for a comminuted, intra-articular distal radius fracture with a temporary spanning plate were identified. Outcomes of bridge plates removed before 10 weeks were compared with plates removed after 12 weeks. Twenty patients in the short duration cohort were compared with 40 patients in the long duration cohort.

Results All fractures healed and there were 10 complications (4 short duration, 6 long duration) and 2 reoperations (1 short duration, 1 long duration) in the study population. There were no significant differences in final Quick-DASH scores (27.4 short duration, 20.9 long duration) or radiographic alignment. Mean values for wrist extension and ulnar deviation were significantly worse in the long duration cohort, although these differences are of unclear clinical significance.

Conclusion It may be safe to remove spanning bridge plates earlier than what is traditionally recommended. Plate removal at or before 10 weeks did not detract from healing or radiographic alignment. Prospective investigations assessing the optimal duration of fixation for this technique are needed.

Level of Evidence This is a Level IV study.

Note

The investigation was performed at the Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA 19107.




Publication History

Received: 28 September 2020

Accepted: 27 November 2020

Article published online:
22 January 2021

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