The functional and radiographical outcome at 5 years of 45 intraarticular radius fractures treated with a dorsal pi-plate and a volar T-plate

Introduction

• A prospective consecutive series of 44 patients with 45 intraarticular distal radius fractures treated by open reduction and internal fixation using volar T-plates and dorsal Pi-plates between 2002 and 2005.
• All patients had an intraarticular distal radius fracture.
• AO staging showed a distribution of 2 B2, 3 C1, 12 C2 and
  28 C3 fractures.
• All 45 fractures were treated with the same method, a volar
  T-plate and a dorsal Pi-plate.
• The patients were assessed clinically after 6 month and clinically and radiographically after 12 month and 5 years.
• At the 6 months follow up strength, the range of motion and
  pain was evaluated.
• After 1 and 5 years strength and range of motion was measured.
  A radiographically staging was performed with the Batra-score system, a VAS-score and also PRWE and DASH.

Results

• 15 men and 29 women
• The mean age was 57,6 (range 24-71 years)
• One patient had a bilateral fracture
• 27 injuries occurred on the dominant limb, 24 on the right hand
• The most common mechanism of trauma was a non high-energy-trauma
• The VAS-score was 1 after 6 month, 0.7 after 12 month and
  0.4 after 5 years (p=0.02)
• The radiographically staging performed with the Batra score
  system showed 30 excellent, 11 good, 3 fair and 1 poor
• The mean PRWE after 5 years was 1.55
• The Quick-DASH was 13.2 and the DASH-activity 12.0

Complications

• We had one patient with numbness in the distal part of digitus III
• One patient with numbness in the nervus medianus area in
  digitus I and II
• One early plate removal because of that the patient couldn’t
  supinate
• Removal of the volar and dorsal plate was performed in
  22 patients (49%).

Conclusion

• The study evaluated the long term results by internal fixation with a volar T-plate and a dorsal Pi-plate for comminute intraarticular distal radius fracture and demonstrate a excellent clinical and anatomical outcome. 
• We consider that the advantage of a steady and anatomical exact reduction is crucial for good long term results.