Wrist Function 1 Year After Complicated Distal Radius Fracture

Abstract

Objective/Hypothesis: Complicated unstable distal radius fractures with damaged joint surface should be managed by open reduction and internal fixation (ORIF). The currently most common method is to stabilize the fracture with a volar fixed-angle locking plate. Combined volar and dorsal ORIF (Pi-plate method) is an alternative, but few previous studies have investigated the outcome after this method. Aim: The aim of this study was to investigate wrist function according to physical functioning, pain, and patient-rated wrist function 1 year postoperatively in patients who underwent ORIF with the Pi-plate method. It was also analyzed the incidence of complications and hardware removal. Material and Methods: This retrospective study involves 116 patients during 1 year. Follow-up results were available for 88. One was excluded because of bilateral fractures. Results: The average wrist motion was 71% to 94% and grip strength was 79% compared with the uninjured hand. Median pain at rest and activity were 0 and 3 measured by Numerical Rating Scale and wrist function was 19.5 measured by Patient-Rated Wrist Evaluation (PRWE). Patients 60 years or older regained function at the same level as those younger than 60 years. There was a moderate correlation between PRWE score and dorsal/volar flexion and relative grip strength, respectively. None of the patients had tendon ruptures or developed complex regional pain syndrome. Hardware was removed in 44%. Conclusions: The conclusion of this study is that patients undergoing combined dorsal and volar ORIF regain good wrist function without complications but that hardware is commonly removed.