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.
Keywords
distal radius - fracture - dorsal - spanning - bridge - plate - fixation - duration
