O3047 OPEN REDUCTION AND PLATE FIXATION OF UNSTABLE DORSALLY DISPLACED FRACTURES OF THE DISTAL RADIUS

Abstract

Aims: The results of open reduction and internal þxation of 24 unstable dorsally displaced fractures of the distal radius are reported. Methods: The fractures occurred in 24 patients (mean age 39) and 17 of these fractures were AO Type C. All fractures were treated with open reduction and subperiosteal placement of dorsal 2.0mm or 2.7mm AO mini-fragment plates between 1st and 2nd dorsal compartments and below the 4th compartment. Additional volar plate þxation was required in 6 cases. Patients were examined and X-rays performed. Outcome was assessed using the Modiþed Mayo Wrist Score and Patient Evaluation Measure. Results: At þnal follow-up (mean 36 months), the mean range of movement of the wrist was: extension 78¡, ßexion 64¡, pronation 82¡ and supination 83¡. Grip strength averaged 84% of the unaffected side. Radiographic assessment showed a mean volar angle of 8¡, articular step in 5 cases and evidence of osteoarthritis in 10 wrists.

The þnal outcome, using the Modiþed Mayo Wrist Score was excellent in 13 cases, good in 7, and fair in 4 cases. Complications were seen in 3 patients and metalwork has subsequently been removed in 7 patients for tendon irritation but there have been no cases of extensor tendon rupture. Conclusions: This initial experience has encouraged the use of open reduction and dorsal plating as the treatment of choice in young patients with unstable and/or intra-articular fractures of the distal radius. With time, range of movement and grip strength, continue to improve.