Treatment of comminuted intra-articular distal radius fractures by open reduction and locking compression plate fixation

Objective To evaluate the treatment results of open reduction and locking compression plate fixation for comminuted intra-articular fractures of the distal radius. Methods Twenty-six patients of distal radius fractures with a mean age of 61 years were involved in this series. The fractures were classified as AO type-C1 in 8 cases , type-C2 in 12 cases, and type-C3 in 6 cases. 2 of those were open fractures. Two patients had concomitant shoulder dislocation and elbow dislocation respectively. All the fractures were treated with open reduction and locking compression plate fixation in a volar approach. Results Follow-up ranged from 6 to 20 months, the average being 8 months. The mean healing time of the fractures was 8 weeks (6～12 weeks). The mean range of motion of the wrist reached 40° of flexion, 45°of extension, 30° of ulnar deviation, 20° of radial deviation, 70° of pronation, and 65° of supination. X rays taken at last follow-up showed an increase of radial styloid length from preoperative 6 mm (-10 mm～10 mm) to 11 mm (8 mm～14 mm). The volar tilt increased from-15° (-40°～10°) to 8° (-5°～15°). The ulnar inclination increased from 12°(-5°～20°) to 20° (10°～25°). The intra-articular step-off decreased from 6mm (1～18 mm) to 0 mm (0～3 mm). Grip strength was 78%(55%～100%) of that of the uninjured side. According to the criteria of Gartland and Werley, the results were excellent in 7 cases, good in 12 cases, fair in 5 cases, poor in 2 cases. Conclusion Locking plate can maintain reduction of the displaced intra-articular fractures of the distal radius . Early movement was allowed, and good wrist function can be achieved.