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Intramedullary Scaffold Fixation of Distal Radius Fractures Compared to Volar Locking Plate
Aaron Mull, MD1; Amy F. Kells, MD, PhD2; Grant M. Kleiber, MD1
1Washington University School of Medicine, St. Louis, MO; 2St. Barnabas Hospital, Bronx, NY

Introduction: The Conventus DRS system (Conventus Orthopaedics, Maple Grove MN) is a nickel-titanium intraosseous device that allows for stabilization of distal radius fractures with an intramedullary scaffold (IMS) and percutaneous cannulated screws (Figure). The purpose of this study is to report our early results with the Conventus implant compared to volar locking plate fixation of distal radius fractures.
Methods: Two groups of 11 patients each were retrospectively identified: patients treated with the IMS device for isolated distal radius fractures from 2014-2015, and patients treated with volar locking plate fixation (Acumed, Beaverton OR) who were matched to the IMS patients based on AO fracture classification and age. Measurements were obtained from postoperative and 4-week radiographs. Subjective outcomes were measured by reviewing Disabilities of the Arm, Shoulder, and Hand (DASH) scores calculated at the first postoperative visit, 4 weeks and 8-12 weeks. Total active motion (TAM) was measured at 4 weeks and again at 8-12 weeks. Variables were compared between the two groups using independent T-tests.
Results: Mean operative time was slightly increased in the IMS group (112 min 38) compared to the volar plate group (98 min 37, p=0.39). Volar plated fractures achieved better volar inclination on postop radiographs (7.6 5.2) compared to the IMS group (3.0 7.8, p=0.12) and maintained volar inclination at 4 weeks compared to the IMS group, which lost on average 1.6 of volar tilt, however this was not statistically significant (p=0.2). Mean DASH scores were lower for the volar plate group compared to the IMS group at initial postop (66 vs 75), 4 week (43 vs 55), and 8-12 week visits (24 vs 30), however this difference was not statistically significant. TAM was similar between the volar plate and IMS groups at 4-week (63 vs 59) and 8-12 week visits (106 vs 101). Two patients experienced EPL tendon rupture one in each group.
Conclusions: IMS fixation provides a less-invasive method of distal radius fracture stabilization. This study found no statistically significant difference between IMS compared to standard volar locking plate fixation with respect to radiographic parameters, postoperative DASH scores, or total range of motion. This study is limited by small sample size, and larger prospective studies are needed to prove equivalence between the two fixation systems. Figure

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