OPEN REDUCTION AND INTERNAL-FIXATION OF UNSTABLE DISTAL RADIUS FRACTURES WITH A LOW-PROFILE PLATE - A MULTICENTER STUDY OF 73 FRACTURES

A study of acute, dorsally displaced, unstable (high-energy) fractures of the distal radius was conducted to determine the safety and effica cy of a new low-profile plate for unstable distal radius fractures. Th irteen surgeons in 11 US cities participated in the study. A minimum f ollow-up period of 1 year was required to be included in the study. Se venty-three fractures in 71 patients met this criterion. Each fracture was treated according to a prospective protocol. An autogenous bone g raft was used in 64 fractures. All procedures were completed using a r adiolucent sterile traction table. No external fixators were used eith er during or after the operation. After bone grafting and while in tra ction, a fracture reduction clamp with a template preshaped to the nor mal contour of the dorsal radial metaphysis molded the fracture into r eduction and then allowed precision drilling of the holes for the plat e. Active wrist motion began at an average of 14 days. Satisfactory op en 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 o utcomes were rated as excellent. This initial report demonstrates that the method is a safe and effective treatment for acute, unstable, dor sally displaced fractures of the distal radius. Copyright (C) 1998 by the American Society for Surgery of the Hand.