Double dorsal locking plates for unstable distal radial fractures

Abstract

Objective To evaluate clinical results of double dorsal locking plates used in the fixation of distal radial fractures.MethodsFrom March 2007 to December 2009, 22 patients with distal radial fractures were fixed with double dorsal anatomical locking plates. They were 12 males and 10 females, with a mean age of 47. 5 years (21 to 78 years). By AO classification, there were one case of type A3, 5 cases of type B2, 2 cases of type C1, 11 cases of type C2 and 3 cases of type C3. Iliac autograft was performed in 5 patients. Clinical results and postoperative functional recovery were assessed by range of motion, grip strength, radiographic measurements of ulnar inclination, palmar tilt and radial height, the DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire and the Gartland-Werley sere.Results The mean follow-up was 19 months (12 to 32 months). All fractures united within 6 months (2 to 6 months). The mean ulnar inclination angle was 25.3° (22° to 29°), the mean palmar tilt angle was 12.1° (8° to 14°), and the mean radial height was 1.1 cm (0.8 to 1.3 cm). The mean radiographic Stewart score was excellent or fine in 90. 9％ of the patients. The mean dorsal extension was 53° (30° to 68°), the mean palmer flexion was 47° (32° to 65°), the mean ulnar inclination was 22° (16° to 30°), the mean radial inclination was 14° (11° to 32°), the mean pronation was 76° (30° to 90°) and the mean supination was 72° (10° to 90°). The mean grip strength of the operated side was 72％ (15 kg) of the normal side. The mean Q-DASH and Gartland-Werley scores were 11.4 (0 to 70) and 3.4 ( 1 to 16), respectively.Conclusions Fixation with double dorsal locking plates for unstable distal radial fractures can result in fine clinical results, especially for those with comminuted dorsal hone cortex. Key words: Radius fractures; Fracture fixation, internal; Bone plates