Spanning Bridge Plate Fixation of Distal Radial Fractures.

Abstract

➢ Dorsal spanning bridge plate fixation offers an option for the surgical treatment of distal radial fractures in the setting of metaphyseal bone loss or diaphyseal extension, complex injuries requiring extensive soft-tissue and osseous reconstruction, or severe osteoporosis. It is also a salvage option after distal radial nonunion.➢ Reduction is performed with use of ligamentotaxis. The plate is fixed from the radial shaft to either the second or third metacarpal, spanning the wrist joint for the duration of fracture-healing, and is removed after fracture consolidation (at approximately 3 months).➢ Surgical fixation to the second metacarpal may increase the risk of damage to the radial sensory nerve, whereas fixation to the third metacarpal may increase digital extensor tendon friction with the plate.➢ There is currently no evidence-based recommendation whether to preferentially affix the plate to the second or third metacarpal. Both options may offer advantages based on the fracture pattern.➢ The functional outcomes and complications associated with this technique are similar to those associated with other methods of fixation of distal radial fractures.