title: Ten Years' Follow-Up on Combined Palmar and Dorsal Internal Fixation of Complex Distal Radius Fractures.
abstract: Complex distal intra-articular radial fractures (AO Type C3) are rare, but are life-changing injuries. They are usually related to high-velocity trauma mechanisms in a working male population.We surveyed a cohort of these fractures treated in our institution to assess the functional long-term outcome.Twelve consecutive patients with comminuted intra-articular distal radial fractures were treated at our institution. Osteosynthesis was performed by a single senior surgeon with volar and dorsal extended approaches. The intermediate and final control included conventional X-ray, range of motion (ROM), grip strength, and the Disabilities of the Arm, Shoulder, and Hand index (DASH), as well as the Patient-rated Wrist Evaluation (PRWE) score for functional outcome at 1 and 10 years' of follow-up.At 10 years' follow-up, anatomic reconstruction with a step or gap of <1 mm was achieved in 10 of the 12 above-mentioned patients, whereas 2 patients were lost to follow-up. ROM was good to excellent in 8 patients. Median grip strength was 107% of the contralateral side. Median DASH-Index and PRWE were 2.3 and 6 respectively, at 10 years. Eight patients returned to premorbid heavy labor. One patient was retired at the time of injury.Combined volar and dorsal approaches allow achieving anatomical reconstruction in comminuted intra-articular distal radius fractures and reveal good functional outcomes at intermediate and long-time follow-up.
authors.affiliation: From the Department of Orthopaedic Surgery and Traumatology (LDI, A-SM-B, TRM, RB), Kantonsspital Lucerne, Lucerne; Department of Surgery (RAD); and Department of Surgery (DAR), Trauma Unit, University Hospital of Basel, Basel, Switzerland.
authors.forename: Lukas Daniel
authors.initials: LD
authors.lastname: Iselin
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Massy-Budmiger
authors.forename: Raoul A
authors.initials: RA
authors.lastname: Droeser
authors.forename: Tobias R
authors.initials: TR
authors.lastname: Mett
authors.forename: Reto
authors.initials: R
authors.lastname: Babst
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Rikli
mesh_terms: D000359:Aftercare / Q000379:methods; D004185:Disability Evaluation; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D018460:Fractures, Comminuted / Q000175:diagnosis / Q000601:surgery; D018737:Hand Strength; D006801:Humans; D000069451:Long Term Adverse Effects / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011859:Radiography / Q000379:methods; D011884:Radius / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology; D011885:Radius Fractures / Q000175:diagnosis / Q000534:rehabilitation / Q000601:surgery; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods / Q000706:statistics & numerical data; D020127:Recovery of Function; D013557:Switzerland; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000503:physiopathology