Outcome of delayed primary internal fixation of distal radius fractures: A comparative study

Yoram A. Weil, Rami Mosheiff, Shimon Firman, Meir Liebergall, Amal Khoury

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction and aim Operative fixation of distal radius fractures using fixed-angle devices has become increasingly common. Although good to excellent results have been reported in acute fractures, little is currently known regarding the fixation of healing displaced distal radius fractures that were presented late. The aim of this study was to evaluate the results of internal fixation of distal radius fractures presented late (>21 days) as compared with an acute-care control group. Methods Forty patients operated on for displaced distal radius fractures, presenting more than 21 days after injury (delayed treatment (DT) group), were compared with 75 age-matched controls with acute fracture repair (≤21 days). The same surgical approach was used in both groups, together with dorsal soft-tissue and brachioradialis release. No osteotomy was required. Direct and indirect reduction aids were used. A fixed-angle device (DVR; Biomet Inc., Warsaw, IN, USA) was used in both groups. Mean follow-up was 3.4 years. Quick DASH (Disabilities of the Arm, Shoulder and Hand) and Short Form 12 scores were used to evaluate outcome, as well as radiographic analysis for Arbeitsgemeinschaft fu;die Osteosynthesefragen(AO)/ Orthopaedic Trauma Association(OTA) classification, volar tilt, radial inclination and radial length. Results Average age was 53 years in both groups and male to female (M/F) ratio was similar in the study groups. Mean time to surgery was 30 days in the DT group and 8 days in the control group. There were significantly more type C (91.5% vs. 67.5%) fractures in the control group. The average quick DASH score was 27.1 in the DT group as compared with 6.3 in the control group (p 0.03); however, when controlling for two outlier cases with complications (hardware irritation and a sensory neuropathy) there was no significant difference. Volar tilt, radial inclination and length were similar in both groups and were within normal anatomical values. Conclusions Delayed primary operative fixation of displaced unstable distal radial fractures is a viable option for cases that were presented late, with predictable, favourable results. Neither extensile approaches nor formal osteotomies are required. ;copy2014 Elsevier Ltd.

Original languageEnglish
Pages (from-to)960-964
Number of pages5
JournalInjury
Volume45
Issue number6
DOIs
StatePublished - Jun 2014
Externally publishedYes

Keywords

  • Delayed surgery
  • Distal radius fractures
  • Volar locking plate

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