Benson, L. S., Minihane, K. P., Stern, L. D., Eller, E., & Seshadri, R.

The Journal of Hand Surgery, 31(8), 1333–1339

Purpose: To assess the clinical, radiographic, and functional outcome of treating intraarticular distal radius fractures with fragment-specific fixation.

Methods: A retrospective review of 81 patients with 85 intra-articular distal radius fractures who were treated with fragment-specific fixation was performed. Minimum time for follow-up evaluation was 1 year, with a mean time of 32 months. The immediate postoperative films were compared with those taken at the final follow-up evaluation. Radiographs of the uninjured wrist were also obtained at the final follow-up evaluation for comparison. Patients were examined for wrist and finger range of motion, deformity, and grip strength, and they completed a standard Disabilities to the Arm, Shoulder, and Hand outcome survey.

Results: According to Gartland and Werley scoring there were 61 excellent and 24 good results. Flexion and extension of the surgically treated wrist at the final follow-up evaluation averaged 85% and 91%, respectively, of the uninjured wrist; grip strength averaged 92% compared with the uninjured side. The average Disabilities to the Arm, Shoulder, and Hand outcome score for the injured wrist was 9. Sixty-two percent of patients achieved a 100* arc of flexion and extension and normal forearm rotations by postoperative week 6. Radiographic alignment was maintained between immediate postoperative and final follow-up films, and there were no cases of symptomatic arthritis at the final follow-up evaluation.

Conclusions: Fragment-specific fixation is a reasonable alternative for treating intra-articular fractures of the distal radius. At final follow-up evaluations, patients had good to excellent results with respect to their range of motion, grip strength, radiographic alignment, and satisfaction scores. Stable fixation allowed starting active and passive motion of the wrist without compromising postoperative alignment. (J Hand Surg 2006;31A:1333-1339. Copyright 20062006 by the American Society for Surgery of the Hand.)

Type of Study/level of evidence: Therapeutic IV