DOS BULLETIN - Dansk Ortopædisk Selskab

2010-378_DOS nr. 3 2010 29/09/10 10:08 Side 94
Complications and functional outcome after internal
fixation of dorsally displaced distal radial fractures
Jeppe Bove, Bjarke Viberg, Pernille Greisen, Jan Schultz Hansen
OUH Svendborg Ortopædkirurgisk afdeling;
OUH Svendborg Radiologisk afdeling
Background: Recently there has been an increasing interest in open
reduction and internal fixation of distal radius fractures. Even so further
studies are still needed.
Purpose: To document the functional outcome and identify complications
among patients treated with a volar locking plate (DVR-locking
plate, DePuy Orthopaedics) newly introduced in our department.
Methods: The study was designed as a historical cohort study. 37
females and 6 males with a mean (CI) age of 72,6 (69,5-75,6) were
included. 35 received 6 months follow up (median 6,4) and 30 received
1 year follow up (median 14,0). Outcome measures included the Disability
of the Arm, shoulder and Hand (DASH) questionnaire, grip
strength, active wrist and forearm range of motion and radiographic
parameters.
Findings: The mean DASH score was 15,5 (10,5- 20,6) at 6 months and
6,3 (2,5-10) at 1 year. There were at 1 year statistical significant difference
between the fractured and non-fractured wrist for flexion, extension
and grip strength but not for supination and pronation. X-rays showed an
improvement from preoperative to postoperative in dorsal angulation
(17,7 degrees), inclination (6,6 degrees) and radial length (4,8 mm). A
total of 10 major complications were identified: 4 had screws in the
joint, 2 tendon ruptures, 2 plates were removed, 1 carpal tunnel syndrome,
1 lacking radiological healing. There were no association
between major complications and the surgeons experience level (> 10
operations). Evaluation of the X-ray images showed 14 cases of too radial
plate placement and 1 one forgotten tower.
Conclusion: The literature describes an overall complication frequency
between 0 and 27%, with a lower frequency of secondary procedures
compared to this study. There is still a need for further studies
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