Journal
JOURNAL OF HAND SURGERY-AMERICAN VOLUME
Volume 40, Issue 8, Pages 1554-1562Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jhsa.2015.05.008
Keywords
Distal radius fracture; bridge plating; distraction plate; functional outcome
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Funding
- University of Washington Department of Orthopaedics Resident Research Grant
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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 retrospectively. 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 1 year 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 were significant decreases in wrist flexion (43 degrees vs 58 degrees), extension (46 degrees vs 56 degrees), and ulnar deviation (23 degrees vs 29 degrees) compared with the contralateral uninjured wrist. Grip strength was 86% and extension torque was 78% of the contralateral wrist. Comparison of dominant and nondominant wrist injuries identified nearly complete recovery of grip (95%) and extension (96%) strength of dominant-sided wrist injuries, compared with grip (79%) and extension (65%) strength 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. There 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. Copyright (C) 2015 by the American Society for Surgery of the Hand. All rights reserved.
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