J Korean Soc Surg Hand.  2014 Mar;19(1):44-51. 10.12790/jkssh.2014.19.1.44.

Dorsal Plate Fixation for Dorsally Displaced Distal Radius Fractures

• Na KT
• Song SW
• Lee YM
• Kang BM

• KMID: 1896926
• DOI: http://doi.org/10.12790/jkssh.2014.19.1.44

Abstract

PURPOSE
The object of this study is to evaluate the clinical and radiographic outcomes of two different kinds of dorsal plating for dorsally displaced distal radius fractures.
METHODS
Forty-three patients with dorsal plate fixation for distal radius fracture were retrospectively reviewed. Twenty-four patients were treated with nonlocking dorsal plate (group I) and nineteen patients with locking dorsal plate (group II). Range of motion and Green and O'Brien score were evaluated as clinical results, and radial inclination, radial length, volar tilt at postoperative and last follow up were evaluated as radiographic results.
RESULTS
According to AO classification system, there were 18 type A fractures, 4 type B fractures, 21 type C fractures. In group I, the mean flexion and extension were 65.0degrees and 65.3degrees, respectively; ulnar and radial deviation were 25.5degrees and 20.8degrees; pronation and supination were 80.0degrees and 80.4degrees. In group II, the mean flexion and extension were 64.5degrees and 67.3degrees, respectively; ulnar and radial deviation were 30.6degrees and 20.6degrees; pronation and supination were 81.4degrees and 78.6degrees. The mean Green and O'Brien score was 94.4 in group I and 92.2 in group II, and 41 patients had satisfactory result. There was no statistical significant difference in clinical results between the groups. Results of postoperative and last follow-up radiographic analyses for mean radial inclination were 23.9degrees and 24.1degrees in group I, respectively, and 24.2degrees and 24.9degrees in group II; radial length were 9.9 mm and 9.7 mm in group I, and 10.1 mm and 9.2 mm in group II; mean volar tilt were 12.2degrees and 13.1degrees in group I, and 14.8degrees and 13.7degrees in group II. There were no statistical significant changes within radiographic parameters. No extensor tendon rupture was reported.
CONCLUSION
Dorsal plate fixation for dorsally displaced distal radius fracture showed satisfactory clinical and radiographic outcomes with low complication rate, regardless of the type of plate.

Keyword

Distal radius; Fracture; Dorsal plate

MeSH Terms

Classification
Follow-Up Studies
Humans
Pronation
Radius Fractures*
Radius*
Range of Motion, Articular
Retrospective Studies
Rupture
Supination
Tendons

Figure

• 

  Fig. 1. Dorsal approach for distal radius fracture. (A) Skin incision over Lister's tubercle with zigzag pattern at dorsal aspect of wrist joint. (B) Subperiosteal elevation after dissection of extensor retinaculum. (C) Dorsal plate fixation after the reduction of fracture site and temporary fixation with K-wires. (D) Proximal half of extensor retinaculum was used to cover plate and distal screws. (E) Distal half of extensor retinaculum was repaired. (F) Extensor pollicis longus tendon was placed as subcutaneous.

• 

  Fig. 2. Sixty-eight-year-old male, with dorsally displaced unstable distal radius fracture, was treated with open reduction and internal fixation using dorsal locking T-plate. (A) Preoperative radiographs show AO A3 type distal radius fracture. (B) Postoperative radiographs show good reduction and fixation. (C) Twelve months later, radiographs show no interval change.

Reference

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