Outcomes analysis of treatment of die-punch fractures of the distal radius with volar plate fixation

Abstract

Objective To evaluate the clinical outcomes of treating die-punch fractures of the distal radius with volar plate fixation. Methods From February 2011 to June 2013, 23 patients with distal radial die-punch fractures were treated with open reduction and volar plate fixation. Based on the different locations of fracture fragments, the die-punch fractures were divided into 3 types: dorsal type, volar type and longitudinal split type. A 2.4 mm T-type plate or 2.4 mm variable angle two-column locking compression plate was used via a FCR approach. Metacarpophalangeal joint and interphalangeal joint movement started early postoperatively. Wrist rehabilitation was initiated 4 weeks after the surgery. Follow-up evaluations included X-rays, wrist range of motion, grip strength and DASH score. Wrist deformity or complications were also recorded. These evaluation parameters were compared among different fracture types or between two plate types. Results All the 23 patients had sufficient follow-up for an average of 22.8 months (range, 13 to 41 months). Radiographs showed that the fracture shad healed and the articular surface was smooth. There were no wrist deformity and other complications. There were no significant differences in wrist motion, grip strength and DASH score among different types of fracture fragments and types of plates. Conclusion The efficacy of volar plate fixation for distal radial die-punch fractures is satisfactory. Key words: Radius fractures; Fracture fixation, internal; Die-punch fracture