Results of fixation of dorsally displaced intra-articular distal radius fractures with non angular stable implants

Objective Intra-articular fractures of the distal radius in young adults comprise a distinet fracture pattern that is diffficuh to manage and associated with a high frequency of post-traumatic arthritis.Restoration of articular congruency and alignment should improve the outcome.Methods In this study we prospectively re- viewed the results of 21 consecutive cases of dorsally displaced intra-articular distal radius fractures which were treated with internal fixation after failing to achieve articular congruency with closed reduction.Results 3 patients were lost to follow-up.For the rest of 18 patients,follow-up time ranges from 18 to 75 weeks the fractures had healed with highly satisfactory radiographic and functional results.The final volar tilt averaged 4.9°;radial inclination 23.9°;radial length 14mm;and articular incongruity,0.1 mm.Wrist motion at final follow-up examination aver- aged flexion 62°,extension 60°,radial deviation 16°,ulnar deviation 27°,pronation 77°and supination 74°.Grip strength averaged 83% of the uninjured side.The overall outcome of 18 patients(94.4%)had a good or excellent result according to the system of Gartland and Werley and 18 patients(72.2%)had a good result according to the modified system of Green and O'Brien at the most recent evaluation.The only complication in this series was a superficial pin tract infection,which was rapidly resolved with removal of pins at 5th week of external fixation. Conclusion Thus restoration of articular congruency and alignment is possible with minimal complication using modern non-angular stable methods of internal fixation.

Objective Intra-articular fractures of the distal radius in young adults comprise a distinct fracture pattern that is difficult to manage and associated with a high frequency of post-traumatic arthritis. Restoration of articular congruency and alignment should improve the outcome. Methods In this study we prospectively reviewed the results of 21 consecutive cases of dorsally displaced intra-articular distal radius fractures which were treated with internal fixation after failing to achieve articular congruency with closed reduction. Results 3 patients were lost to follow-up. For the rest of 18 patients, follow-up time ranges from 18 to 75 weeks the fractures had healed with highly satisfactory radiographic and functional results. The final volar tilt averaged 4.9°; radial inclination 23.9°; radial length 14mm; and articular incongruity, 0. 1 mm. Wrist motion at final follow-up examination averaged flexion 62°, extension 60°, radial deviation 16°, ulnar deviation 27°, pronation 77° and supination 74°. Grip strength averaged 83% of the uninjured side. The overall outcome of 18 patients （94.4%） had a good or excellent result according to the system of Gartland and Werley and 18 patients （72.2%） had a good result according to the modified system of Green and O＇Brien at the most recent evaluation. The only complication in this series was a superficial pin tract infection, which was rapidly resolved with removal of pins at 5th week of external fixation. Conclusion Thus restoration of articular congruency and alignment is possible with minimal complication using modem non-angular stable methods of internal fixation.