title: Intra-articular comminution worsens outcomes of distal radial fractures treated by open reduction and palmar locking plate fixation.
abstract: We studied 50 patients with AO type C2 distal radial fractures and 35 with AO type C3 distal radial fractures treated by open reduction and palmar locking plate fixation. At 3-month clinical assessments, mean wrist flexion arcs, grip strengths and disabilities of the arm, shoulder and hand scores were significantly better for AO type C2 fractures. At 2-year post-operative clinical assessments, mean disabilities of the arm, shoulder and hand scores were significantly better for AO type C2 fractures than for AO type C3 fractures. At 2-year radiographic examinations, anterior angulations, ulnar variances and arthritis grades were also significantly better for AO type C2 fractures. This study showed that AO type C3 distal radial fractures, which have intra-articular comminution, had poorer clinical and radiographic outcomes than AO type C2 fractures, despite open reduction and palmar locking plate fixation.
  
  
  METHODS
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authors.affiliation: 1 Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: J O
authors.initials: JO
authors.lastname: Yoon
authors.affiliation: 2 Department of Orthopedic Surgery, Ewha Womans Universtiy Mokdong Hospital, Seoul, South Korea.
authors.forename: S L
authors.initials: SL
authors.lastname: You
authors.affiliation: 1 Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: J K
authors.initials: JK
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005593:Fracture Fixation, Internal; D018460:Fractures, Comminuted / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D057072:Intra-Articular Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D053401:Palmar Plate / Q000601:surgery*; D011885:Radius Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D014955:Wrist Joint; D055815:Young Adult
keywords: Distal radius fracture; comminuted intra-articular fracture; palmar locking plate