Download PDF
J Wrist Surg 2020; 09(05): 388-395
DOI: 10.1055/s-0040-1712503
Scientific Article

Combined Plating of Intra-Articular Distal Radius Fractures, a Consecutive Series of 74 Cases

Authors

  • Marcus Sagerfors

    1   Department of Hand Surgery, Faculty of Medicine and Health, Örebro University, SE, Örebro, Sweden

  • Eva Lundqvist

    1   Department of Hand Surgery, Faculty of Medicine and Health, Örebro University, SE, Örebro, Sweden

  • Patrik Bjorling

    1   Department of Hand Surgery, Faculty of Medicine and Health, Örebro University, SE, Örebro, Sweden
Further Information
   Permissions and Reprints
Preview

Abstract

Background The distal radius fracture (DRF) is the most common fracture in adults. For unstable intra-articular fractures, the choice of treatment is often operative. The optimal choice of fixation remains a matter of discussion.

Question/Purpose Can combined volar and dorsal plating, using a dorsal frame plate, achieve a good functional and radiographic 1-year outcome in intra-articular DRFs?

Methods In a retrospective cohort study, we evaluated 74 consecutive patients operated with combined plating using a volar plate and a dorsal frame plate. The DRFs were operated between 2016 and 2017 and all cases were AO type C intra-articular fractures. The primary outcome was patient-reported outcome measures including radiographic examination 1 year postoperatively. Secondary outcome measures included wrist range of motion, visual analog scale (VAS) pain scores, and hand grip strength.

Results The median patient-rated wrist evaluation score was 18 points; the quick disabilities of the arm, shoulder, and hand score was 14.8 points. The median Batra radiographic score was 88. Wrist extension was 76% of the uninjured side, flexion was 74%, pronation was 94%, and supination was 94%. VAS pain scores were 0 at rest and 2 during activity. Hand grip strength was 82% compared with the uninjured side. The radiographic outcome according to Batra did not correspond to the patient-reported outcome. Patients older than 60 years had significantly better QuickDASH (quick disabilities of the arm, shoulder, and hand) and PRWE scores (patient-rated wrist evaluation scores) and less pain during activity compared with younger patients despite similar radiographic outcome. There were no tendon ruptures; hardware removal was performed in 21 of the 74 patients.

Conclusion The radiographic outcome did not correspond to the functional outcome 1 year postoperatively. Older patients report less pain and better functional outcome compared with younger patients. There were no tendon ruptures and the frequency of hardware removal was acceptable. Complex intra-articular DRFs AO type C can be managed with volar and dorsal frame-plate fixation to restore distal radius anatomy and achieve a good functional outcome.

Keywords

distal radius fracture - plating - range of motion - visual analog scale

Ethical Approval

The study was approved by the Swedish Ethical Review Authority number 2019–00089.




Publication History

Received: 05 December 2019

Accepted: 07 April 2020

Article published online:
17 June 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.