Lauder A, Agnew S, Karim B, Allan C, Hanel D, Huang J

The Journal of Hand Surgery, 40(8), 1554–1562

Purpose: To determine the functional outcomes of patients treated with dorsal spanning distraction bridge plate fixation for distal radius fractures.

Methods: All adult patients at our institution who underwent treatment of a unilateral distal radius fracture using a dorsal bridge plate from 2008 to 2012 were identified restrospectively. Patients were enrolled in clinical follow-up to assess function. Wrist range of motion, grip strength, and extension torque were measured systematically and compared with the contralateral, uninjured wrist. Patients also completed Quick-Disabilities of the Arm, Shoulder, and hand and Patient-Rated Wrist Evaluation outcomes questionnaires.

Results: Eighteen of 100 eligible patients, with a minimum of 1year from the time of implant removal, were available for follow-up (mean, 2.7 y). All fracture patterns were comminuted and intra-articular (AO 23.C3). There are significant decreases in wrist flexion (43* vs 58*), extension (46* vs 56*), and ulnar deviation (23* vs 29) compared with the contralateral wrist. Comparison of dominant and non dominant wrist injuries identified nearly complete recovery of grip (95%) and extension (96%) strenght of dominant-sided wrist injuries, compared with grip (79%) and extension (65%) strenght in those with an injured nondominant wrist. Mean Quick-Disabilities of the Arm, Shoulder, and Hand and Patient-Rated Wrist Evaluation scores were 16 and 14, respectively. These were 2 cases of postoperative surgical site pain and no cases of infection, tendonitis, or tendon rupture.

Conclusions: Distraction bridge plate fixation for distal radius fractures is safe with minimal complications. Functional outcomes are similar to those published for other treatment methods. (J Hand Surg Am. 2015;40(8):1554-1562. Copyright 2015 by the American Society for Surgery of the Hand. All rights reserved).
Type of study / level of evidence: Therapeutic IV