title: Two peg spade plate for distal radius fractures: A novel technique.
abstract: BACKGROUND
  The management of distal radius fractures raises considerable debate among orthopedic surgeons. The amount of axial shortening of the radius correlates with the functional disability after the fracture. Furthermore, articular incongruity has been correlated with the development of arthritis at the radiocarpal joint. We used two peg volar spade plate to provide a fixed angle subchondral support in comminuted distal radius fractures with early mobilization of the joint.
  
  
  METHODS
  Forty patients (26 males and 14 females) from a period between January 2009 and December 2011 were treated with two peg volar spade plate fixation for distal radius fracture after obtaining reduction using a mini external fixator. Patients were evaluated using the demerit point system of Gartland and Werley and Sarmiento modification of Lindstrom criteria at final followup of 24 months.
  
  
  RESULTS
  The average age was 43.55 years (range 23-57 years). Excellent to good results were seen in 85% (n = 34) and in all patients when rated according to the demerit point system of Gartland and Werley and Sarmiento modification of Lindstrom criteria, respectively. Complications observed were wrist stiffness in 5% (n = 2) and reflex sympathetic dystrophy in 2.5% (n = 1).
  
  
  CONCLUSIONS
  The two peg volar spade plate provides a stable subchondral support in comminuted intraarticular fractures and maintains reduction in osteoporotic fractures of the distal radius. Early mobilization with this implant helps in restoring wrist motion and to prevent development of wrist stiffness.
authors.affiliation: Department of Orthopaedics, Hardikar Hospital, Pune, Maharashtra, India.
authors.forename: Sharad M
authors.initials: SM
authors.lastname: Hardikar
authors.affiliation: Department of Orthopaedics, Hardikar Hospital, Pune, Maharashtra, India.
authors.forename: Sreenivas
authors.initials: S
authors.lastname: Prakash
authors.affiliation: Department of Orthopaedics, Hardikar Hospital, Pune, Maharashtra, India.
authors.forename: Madan S
authors.initials: MS
authors.lastname: Hardikar
authors.affiliation: Department of Orthopaedics, Hardikar Hospital, Pune, Maharashtra, India.
authors.forename: Rohit
authors.initials: R
authors.lastname: Kumar
keywords: Colles fractures; Fracture fixation; bone plates; distal radius fractures; external fixators; radius fractures; volar plates