Functional Outcomes Following Bridge Plate Fixation for Distal Radius Fractures

Alexander Lauder; Sonya Agnew; Karim Bakri; Christopher H Allan; Douglas P Hanel; Jerry I Huang

doi:10.1016/j.jhsa.2015.05.008

Functional Outcomes Following Bridge Plate Fixation for Distal Radius Fractures

J Hand Surg Am. 2015 Aug;40(8):1554-62. doi: 10.1016/j.jhsa.2015.05.008. Epub 2015 Jul 2.

Authors

Alexander Lauder¹, Sonya Agnew², Karim Bakri³, Christopher H Allan⁴, Douglas P Hanel⁴, Jerry I Huang⁴

Affiliations

¹ Department of Orthopaedics, University of Washington, Seattle, WA. Electronic address: lauder@uw.edu.
² Division of Plastic Surgery, Northwestern University, Jesse Brown VAMC, Chicago, IL.
³ Division of Plastic Surgery, Mayo Clinic, Rochester, MN.
⁴ Department of Orthopaedics, University of Washington, Seattle, WA.

PMID: 26143028
DOI: 10.1016/j.jhsa.2015.05.008

Abstract

Purpose: To determine the functional outcomes of patients treated with dorsal spanning distraction bridge plate fixation for distal radius fractures.

Methods: All adult patients at our institution who underwent treatment of a unilateral distal radius fracture using a dorsal bridge plate from 2008 to 2012 were identified retrospectively. Patients were enrolled in clinical follow-up to assess function. Wrist range of motion, grip strength, and extension torque were measured systematically and compared with the contralateral, uninjured wrist. Patients also completed Quick-Disabilities of the Arm, Shoulder, and Hand and Patient-Rated Wrist Evaluation outcomes questionnaires.

Results: Eighteen of 100 eligible patients, with a minimum of 1 year from the time of implant removal, were available for follow-up (mean, 2.7 y). All fracture patterns were comminuted and intra-articular (AO 23.C3). There were significant decreases in wrist flexion (43° vs 58°), extension (46° vs 56°), and ulnar deviation (23° vs 29°) compared with the contralateral uninjured wrist. Grip strength was 86% and extension torque was 78% of the contralateral wrist. Comparison of dominant and nondominant wrist injuries identified nearly complete recovery of grip (95%) and extension (96%) strength of dominant-sided wrist injuries, compared with grip (79%) and extension (65%) strength in those with an injured nondominant wrist. Mean Quick-Disabilities of the Arm, Shoulder, and Hand and Patient-Rated Wrist Evaluation scores were 16 and 14, respectively. There were 2 cases of postoperative surgical site pain and no cases of infection, tendonitis, or tendon rupture.

Conclusions: Distraction bridge plate fixation for distal radius fractures is safe with minimal complications. Functional outcomes are similar to those published for other treatment methods.

Type of study/level of evidence: Therapeutic IV.

Keywords: Distal radius fracture; bridge plating; distraction plate; functional outcome.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Bone Plates*
Female
Follow-Up Studies
Fracture Fixation, Internal*
Hand Strength
Humans
Male
Middle Aged
Radius Fractures / surgery*
Range of Motion, Articular
Retrospective Studies
Treatment Outcome