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The Weber Clamp Dorsal Compression Technique Provides Improved Radiographic and Similar Clinical Outcomes Compared to Conventional Distal Radius Fracture Reduction
Victor T. Hung, M.D.
1, Tantien Nguyen, BS
2, Joshua U. Hancock, BS
2, Sofia Restrepo, BA
3, Braden Mattison, MD
4; James J. Creighton III, MD
5(1)Foundation for Orthopaedic Research and Education, Tampa, FL, (2)Foundation For Orthopaedic Research and Education, Tampa, FL, (3)Morsani College of Medicine, University of South Florida, Tampa, FL, (4)Loma Linda Univeristy, Loma Linda, CA, (5)Florida Orthopaedic Institute, Temple Terrace, FL
IntroductionOpen reduction and internal fixation (ORIF) of distal radius fractures (DRFs) with the modified Henry approach is effective for restoring anatomic alignment. Recently, a novel Weber clamp dorsal compression reduction technique (DCRT) was described in the literature to improve upon the conventional reduction by utilizing a rolled towel dorsally to distribute the compressive forces elicited by the Weber clamp while also mitigating skin complications (Figure 1). We hypothesize that the modified Henry approach using the DCRT technique will result in improved plate positioning and less complications or additional procedures needed compared to a conventional reduction.
MethodsA retrospective cohort study of patients undergoing ORIF for DRFs between 2022 and 2024 was performed with patients identified via CPT codes. Patients required volar plate fixation of isolated DRFs for inclusion, while those with inadequate follow-up, alternative hardware, or concomitant fractures were excluded. Cohorts were matched for age, sex, BMI, and key comorbidities.
Results100 matched pairs were found (Table 1). Changes in QuickDASH scores were similar between groups, but the DCRT group showed significantly better volar plate positioning based on Soong grades (Table 2). Rates of complications and hardware removals were not significantly different (Table 3). Additionally, although tourniquet time was longer in the DCRT group, they required similar operative time and fewer intraoperative procedures, including a lower rate of brachioradialis tenotomy (Table 4).
Conclusion The DCRT provides improved radiographic and equivalent clinical outcomes without increasing operative time for ORIF of DRFs. The lower rate of brachioradialis tenotomy suggests that less aggressive fracture reduction is necessary. This technique and approach can be helpful in providing volar tilt while avoiding volar plate prominence during ORIF of DRFs.
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