Radiographic outcomes of dorsal spanning plate with and without volar plate fixation for comminuted intraarticular distal radius fractures.

PURPOSE: Dorsal spanning plate fixation for comminuted intra-articular distal radius fractures involves indirect reduction via ligamentotaxis, potentially resulting in suboptimal restoration of native anatomy. Displaced volar fragments may necessitate separate buttress support with a volar plate. This objective of this study was to retrospectively compare radiographic outcomes between distal radius fractures managed with dorsal spanning plate fixation alone versus dorsal spanning plate fixation with concomitant volar plating.

METHODS

A retrospective review identified 51 distal radius fracture cases treated with dorsal spanning plate fixation, with 35 receiving isolated dorsal spanning plate fixation and 16 receiving dorsal spanning plate fixation with a concomitant volar plate. Radiographic parameters were measured at plate application and removal.

RESULTS

Final radiographs for isolated dorsal spanning plate fixation vs. dorsal spanning and volar plate fixation showed similar outcomes: radial height (9.3 mm vs. 8.9 mm, p = 0.8), ulnar variance (-2.77 mm vs. -2.47 mm, p = 0.76), radial inclination (18.8° vs. 16.3°, p = 0.21), volar tilt (1.3° vs. 2.8°, p = 0.45), and teardrop angle (48.9° vs. 51.0°, p = 0.32). Little to no loss of radiographic alignment was observed between time points.

CONCLUSIONS

Radiographic outcomes for distal radius fractures treated with dorsal spanning plate fixation alone versus dorsal spanning plate and volar plate fixation are comparable, with suboptimal restoration of volar tilt and teardrop angle.

LEVEL OF EVIDENCE: Therapeutic IV.