title: Comparison of intra-articular simple compression and extra-articular distal radial fractures.
abstract: BACKGROUND
  The impact of a single well-reduced or stable intra-articular fracture oriented in the sagittal plane on the outcome of internal fixation of a distal radial fracture is uncertain. We tested the hypothesis that wrist motion and function scores would not differ between patients with an extra-articular fracture and those with a single sagittal intra-articular fracture following open fracture reduction and internal fixation with use of a volar locking plate.
  
  
  METHODS
  Thirty-seven patients with a single sagittal intra-articular fracture of the distal aspect of the radius and seventy-four age and sex-matched patients with an extra-articular distal radial fracture were retrospectively analyzed with use of data gathered in a cohort study of plate and screw fixation of distal radial fractures. A volar locking plate was used in all patients. The two cohorts were analyzed for differences in motion, grip strength, pain, and Gartland and Werley, DASH (Disabilities of the Arm, Shoulder and Hand), and SF-36 (Short Form-36) scores six, twelve, and twenty-four months after surgery. Differences between the cohorts and differences within each cohort over time were determined with use of regression analysis and the likelihood ratio test.
  
  
  RESULTS
  Patients with a single sagittal intra-articular fracture and those an extra-articular fracture did not differ significantly with respect to motion, grip strength, Gartland and Werley score, or DASH score at any time point. However, there was a trend toward less pronation (95% compared with 98% of that in the contralateral arm) and less grip strength (76% compared with 81% of that in the contralateral arm) at six months and toward a smaller flexion-extension arc (118° compared with 128°) at one year after surgery in patients with a single sagittal intra-articular fracture.
  
  
  CONCLUSIONS
  Open reduction and volar locking plate and screw fixation of extra-articular fractures and of simple intra-articular fractures of the distal aspect of the radius are associated with comparable impairment and disability within two years of surgery.
authors.affiliation: Massachusetts General Hospital, Yawkey 2100, 55 Fruit Street, Boston, MA 02114, USA.
authors.forename: J Sebastiaan
authors.initials: JS
authors.lastname: Souer
authors.forename: David
authors.initials: D
authors.lastname: Ring
authors.forename: Jesse
authors.initials: J
authors.lastname: Jupiter
authors.forename: Stefan
authors.initials: S
authors.lastname: Matschke
authors.forename: Laurent
authors.initials: L
authors.lastname: Audigé
authors.forename: Marta
authors.initials: M
authors.lastname: Marent-Huber
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D001863:Bone Screws; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology*; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult