AAHS Home  |  2021 Virtual Portal  |  Past & Future Meetings
Countdown to AAHS : 33 Days  
American Association for Hand Surgery

Back to 2022 Abstracts


Outcomes After Dorsal Spanning Plate Fixation For Distal Radius Fractures
Matthew Defazio, MD1, Natalie Godfrey, MD1, Evan Offord, BS2, Emmanuel Budis, BS1 and Marci Jones, MD3, (1)University of Massachusetts, Worcester, MA, (2)University of Massachuessets, Worcester, MA, (3)Department of Orthopedics, University of Massachusetts, Worcester, MA

Introduction:
Distal radius fractures (DRFs) are some of the most common fractures seen in adults. They are commonly fixed with volar locking plates but there remain indications for alternative types of fixation, like the dorsal spanning plate. Dorsal plate fixation acts as an internal fixator that uses ligamentotaxis to maintain length and joint integrity and are indicated in severely comminuted fractures. There is a relative paucity of outcomes and complications data after dorsal plating in the current literature. The aim of our study was to conduct a retrospective review to investigate DRFs fixed with a dorsal spanning plate and review additional procedures, complications, and outcomes.
Materials & Methods:
DRFs fixed via dorsal spanning plate at a level-one trauma center were retrospectively identified via CPT coding and chart review over a 5-year period from 2014-2019. Patient demographics, fracture pattern characteristics, fixation techniques, and clinical outcomes were all obtained via chart review using the EMR.
Results:
43 dorsal plates were identified out of 369 DRF open reduction external fixations (11.6%). Of these, 27 (63%) were female with an average age of 58 years. Additionally, 36 (84%) were AO type C, 12 (28%) were open fractures, and 34 (79%) resulted from falls.
At the time of dorsal plating, 11 of the 43 (25%) had an additional procedure. These included: k-wire fixation, carpal tunnel release, bone grafting, distal ulna resection, mini suture anchors, tendon/nerve repair. Only 1 patient had a major complication requiring an additional procedure for a radius nonunion and required a volar plate with bone grafting with ultimate fracture union.
Clinically, at an average final follow up of 9 weeks after dorsal plate removal the mean range of motion was: 36 degrees flexion, 46 degrees extension, 74 degrees pronation, and 62 degrees supination. These are comparable to prior outcomes in the literature using alternative fixation and demonstrate good functional range of motion.
Conclusions:
Overall, the dorsal spanning plate is a safe and effective procedure in treating complex DRFs. In our series, there was only 1 major complication with nonunion requiring re-operation. We also saw good functional outcomes at an early interval despite poor compliance with occupational therapy. Further studies are needed with a larger cohort and improved long term follow up to further characterize outcomes after dorsal plating for DRFs.


Back to 2022 Abstracts