title: Palmar multidirectional fixed-angle plate fixation in distal radius fractures: do intraarticular fractures have a worse outcome than extraarticular fractures?
abstract: BACKGROUND
  The results and complications using a palmar plate system with the possibility of multidirectional fixed-angle screw fixation (Aptus® Radius 2.5 mm by Medartis®) for the treatment of unstable distal radius fractures were evaluated in a single cohort study including 62 patients.
  
  
  METHODS
  Patients with extra- and intraarticular fractures were evaluated separately. The mean follow-up was 14.7 months. Active wrist motion averaged 60.1° extension, 52.0° flexion, 86.3° pronation, and 84.6° supination. Grip strength averaged 89% of the contralateral wrist.
  
  
  RESULTS
  There was no loss of the initial reduction with bony union in all cases. The mean DASH-score was 12.6 points. Postoperative complications included two extensor pollicis longus tendon ruptures, two median nerve compression syndromes, one complex regional pain syndrome, and one postoperative haematoma. In our series the results of the intraarticular fracture group were similar to the extraarticular fracture group. The complication rate, however, was substantially higher in the intraarticular fracture group.
  
  
  CONCLUSIONS
  We conclude that palmar plating with multidirectional fixed-angle screw insertion is an effective and useful treatment option, especially for complex intraarticular distal radius fractures.
authors.affiliation: Department of Hand, Plastic and Reconstructive Surgery, Kantonsspital, St. Gallen, Switzerland. juerg.sonderegger@kssg.ch
authors.forename: Juerg
authors.initials: J
authors.lastname: Sonderegger
authors.forename: S
authors.initials: S
authors.lastname: Schindele
authors.forename: M
authors.initials: M
authors.lastname: Rau
authors.forename: J G
authors.initials: JG
authors.lastname: Gruenert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D015331:Cohort Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011885:Radius Fractures / Q000601:surgery*; D014954:Wrist Injuries / Q000601:surgery; D014955:Wrist Joint; D055815:Young Adult