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

Investigation performed at the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

Tamara D. Rozental, MD
Pedro K. Beredjiklian, MD
David J. Bozentka, MD
University of Pennsylvania School of Medicine, 39th and Market Streets, 1 Cupp Pavilion, Presbyterian Medical Center, Philadelphia, PA. E-mail address for P.K. Beredjiklian: pedro.beredjiklian{at}uphs.upenn.edu

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

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Background: There 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.

Methods: The 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.

Results: Twenty-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 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 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).

Conclusions: Patients in whom a dorsally displaced distal radial fracture is treated with a titanium or stainless-steel Synthes 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 Evidence: Therapeutic study, Level III-2 (retrospective cohort study). See Instructions to Authors for a complete description of levels of evidence.

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This article has been cited by other articles:

				F. Leung, Y.-k. Tu, W. Y.C. Chew, and S.-P. Chow Comparison of External and Percutaneous Pin Fixation with Plate Fixation for Intra-articular Distal Radial Fractures J. Bone Joint Surg. Am., August 1, 2008; 90(8): 1784 - 1785. [Full Text] [PDF]

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