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Posttraumatic arthritis after combined plating of distal radius fracture AO type C, 97 cases with seven-year follow-up
Eva Lundqvist, MD1, Per Fischer, MD, PhD2, Per Wretenberg, MD, PhD1, Wolfgang Krauss, MD3 and Marcus Sagerfors, MD, PhD1, (1)Orebro university, Orebro, Sweden, (2)Örebro Universitet, Örebro, Sweden, (3)Örebro University, Örebro, Sweden

Background
The volar locking plate is the most common method of operative fixation of distal radius fractures (DRF). For more complex cases, combined plating can be an option in stabilizing intra-articular fragments. However, the prevalence of posttraumatic arthritis (PA) after an intra-articular DRF and its relation to patient-related outcome measures remains unclear. The purpose of this study was to study the prevalence of PA and its correlation to clinical outcome measures.
Methods
We evaluated 97 consecutive patients with DRF, operated with combined plating seven years postoperatively. The primary outcome measure was prevalence of radiographic PA. Secondary outcome measures included visual analog scale (VAS) pain score, hand grip-strength, wrist range of motion (ROM), Patient-Rated Wrist Evaluation-score (PRWE) and Quick Disabilities of the Arm, Shoulder and Hand-score (QuickDASH). Radiographic examination was performed 1 year and 7 years postoperatively.
Results
The prevalence of PA was 29 % at the 7-year follow-up. No correlation was found between PA and, ROM, hand grip-strength, PRWE, QuickDASH or VAS pain-scores. Median wrist ROM and grip strength were significantly inferior compared to the uninjured side. Hardware removal was performed in 51.5 % of cases. There was two cases of tendon ruptures.
Conclusions
Combined plating can yield a good clinical outcome 7 years postoperatively and a low prevalence of PA. The presence of PA did not correlate to clinical outcome measures or the accuracy of anatomical reduction one year postoperatively. The frequency of tendon ruptures was acceptable, but the high frequency of hardware removals is a concern.


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