Functional Outcome and Complications Following Two Types of Dorsal Plating for Unstable Fractures of the Distal Part of the Radius

• Published in: Journal of bone and joint surgery. American volume 2003-10, Vol.85 (10), p.1956-1960
• Main Authors: Rozental, Tamara D, Beredjiklian, Pedro K, Bozentka, David J
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Bone Plates - adverse effects; Cohort Studies; Female; Follow-Up Studies; Fracture Fixation, Internal - adverse effects; Fractures, Comminuted - diagnosis; Fractures, Comminuted - physiopathology; Fractures, Comminuted - surgery; Humans; Male; Medical sciences; Middle Aged; Orthopedic surgery; Radius Fractures - diagnosis; Radius Fractures - physiopathology; Radius Fractures - surgery; Recovery of Function - physiology; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome
• ISSN: 0021-9355; 1535-1386
• DOI: 10.2106/00004623-200310000-00014

BackgroundThere is a paucity of data in the literature documenting the functional outcomes for patients who have been managed with a dorsal plate because of a distal radial fracture. The purpose of the present study was to determine the functional outcome and complications following dorsal plating for dorsally displaced, unstable fractures of the distal part of the radius.MethodsThe records of all patients who had been managed at our institution with dorsal plating because of a comminuted, dorsally displaced fracture of the distal part of the radius were reviewed. Patients with less than twelve months of follow-up were excluded from the study. Outcomes were evaluated at the time of the latest follow-up with use of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and the Gartland and Werley scoring system.ResultsTwenty-eight patients (nineteen women and nine men) with a mean age of forty-two years formed the basis of the study. The mean duration of follow-up was twenty-one months. Nineteen patients had been treated with a Synthes π plate, and nine had been treated with a low-profile plate. There were no instances of loss of reduction, malunion, or nonunion. The mean score on the DASH questionnaire was 14.5 points. All patients had an excellent (nineteen patients) or good (nine patients) result according to the scoring system of Gartland and Werley. Nine patients had postoperative complications requiring repeat surgical treatment for hardware removal or extensor tendon reconstruction. All nine reoperations were performed in patients who had been treated with a Synthes π plate, while none were performed in patients who had been treated with a low-profile plate (p < 0.025). Four complications occurred in patients who had been treated with a titanium plate, and five complications occurred in patients who had been treated with a stainless-steel plate (p = 0.71).ConclusionsPatients in whom a dorsally displaced distal radial fracture is treated with a titanium or stainless-steel Synthes π plate have a significantly increased risk of complications compared with those in whom such a fracture is treated with a low-profile plate. Regardless of the type of plate used, all of the patients in the present study had a good or excellent long-term functional outcome.Level of EvidenceTherapeutic study, Level III-2 (retrospective cohort study). See Instructions to Authors for a complete description of levels of evidence.