Open reduction and internal fixation of unstable distal radius fractures with a low-profile plate: a multicenter study of 73 fractures.

Abstract

A study of acute, dorsally displaced, unstable (high-energy) fractures of the distal radius was conducted to determine the safety and efficacy of a new low-profile plate for unstable distal radius fractures. Thirteen surgeons in 11 US cities participated in the study. A minimum follow-up period of 1 year was required to be included in the study. Seventy-three fractures in 71 patients met this criterion. Each fracture was treated according to a prospective protocol. An autogenous bone graft was used in 64 fractures. All procedures were completed using a radiolucent sterile traction table. No external fixators were used either during or after the operation. After bone grafting and while in traction, a fracture reduction clamp with a template preshaped to the normal contour of the dorsal radial metaphysis molded the fracture into reduction and then allowed precision drilling of the holes for the plate. Active wrist motion began at an average of 14 days. Satisfactory open reduction was obtained in 93% of the fractures and maintained in 88%. Ninety-five percent of the fractures demonstrated good or excellent outcomes using a standardized evaluation. Eighty-one percent of the outcomes were rated as excellent. This initial report demonstrates that the method is a safe and effective treatment for acute, unstable, dorsally displaced fractures of the distal radius.