We feel that for a common fracture such as distal radial fractures an ideal implant should be easily reproducible with a low complication rate.
We therefore compared the fixation strength achieved with simple suture, by bone anchor and by interference screw (Mini Bio-suture Tack and 3mm Biotenodesis interference screw, Arthrex, UK).
The aims of this study were to determine union rates and hardware complications, and to assess whether the “non-toggle” proximal locking option prevented screw back-out.
Thirty-six fractures (95%) went on to unite following treatment with the Polarus nail. Of the two fractures that failed to unite one had an infective non-union and the other developed avascular necrosis with non-union of the surgical neck. Twelve patients (32%) developed post-operative hardware complications. In nine (24%) there was backing out of the proximal locking screws, but only two patients had symptoms requiring screw removal. In five patients (13%) the nail was prominent proximally, causing impingement. In one patient (3%) the proximal screws penetrated the gleno-humeral joint, although this was asymptomatic. There was backing-out in six of the 21 patients (29%) in which the standard 5.0 mm proximal locking screws were used. This compared with three out of 14 patients (21%) in which the 5.3 mm “non-toggling” screws were used. The difference in the rate of screw backing-out between the two groups was significant (P = 0.0474, Fisher’s Exact test). In three patients a mixture of 5.0 and 5.3 mm screws was used.