Open reduction and T-plate with tension band fixation of comminuted intra-articular fractures of the distal radius

Objective To study the clinical outcomes of treatment using T-plate and screws with limited tension band fixatiion in comminuted intra-articular fractures of the distal radius. Methods 16 cases of comminuted intra-articular distal radial fractures were treated with open reduction and internal fixation. There were 6 males and 10 females with an average age of 33 years (range, 19～66 years). They were classified into C2 and C3 types according to AO classification. After anatomical reduction, the fractures were fixed with T-plate and screws with addition of limited tension band. Results All the patients were followed-up for 12～16 months, and evaluated by X-rays and wrist function assessment. 8 cases were graded as excellent, 6 good, and 2 fair. The overall satisfaction rate was 87.5%. Preoperatively, the palmar tilt angle ranged from-35°～0° (-15° on average) and the radial inclination angle was -20° to 15° (9.5° on average). After the operation, the two angles were reduced to 7° to 14° (10° on average), and 18° to 24° (21.1° on average) respectively. No severe complications were found. Conclusion For type C2 and type C3 comminuted intra-articular fractures of the distal radius, T-plate with limited tension band fixation is a good method. It can firmly hold the reduced fracture segments and hence facilitate early postoperative rehabilitation.