Abstract
Introduction: Previously, we noticed loss of initial reduction with conventional palmar plate osteosynthesis for dorsally displaced distal radius fractures. Locking Compression T plate may provide more stable fixation and we report our early experience.
Materials and methods: Between November 2002 and April 2003, 23 patients (15 women, 8 men), mean age 55, (17–80) underwent open reduction and internal fixation using 3.5 mm locking compression oblique T plate (SYNTHES) through a Henry ‘s approach and a 2 weeks plaster cast immobilisation. All fractures were dorsally displaced. According to AO classification there were 15 A3 and 8 C1 and C2 fracture. 18 patients could be reviewed with a mean follow up of 16 months (6 to 30) Pre operatively, radial inclination was 11.7 ° (0–20), dorsal angulation 25.9 ° (8–48) and ulnar variance:4 mm (0–10)
Results: Post-operatively, radial inclination was 23,2. ulnar variance: 1,2 mm and ventral angulation 4,6 °. At one year follow-up, there was no loss of post-operative reduction. According to SOFCOT ‘s criteria, there were 13 anatomical results and 5 moderate malunion. According to Green and O ‘Brien’s criteria, there were 9 excellent, 6 good, 3 fair and no poor results. Mean DASH score was 22.8 (5.8 – 62.5). Strengh and pinch were respectively 95 % and 91 % when compared with the opposite side. There were 6 complications concerning 4 reflex sympathetic dystrophy, one carpal tunnel syndrome and one hypertrophic scar.
Discussion: In our experience, classic palmar plate fixation showed inability for maintaining reduction during time. Locking Compression 3,5 T plate by a palmar approach which is a demanding technique, avoids loss of post-operative recution
Conclusion Locking Compression 3.5 T Plate by palmar approach is an effective treatment for dorsally displaced distal radius fracture but the plate itself and ancillary tools have to be improved to reduce operatively difficulty.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
