The pi plate: an implant for unstable extension fractures of the distal radius in patients with osteoporotic bone.

Extension fractures of the distal radius are very common injuries in elderly women caused by moderate energy trauma. Nevertheless there is no consensus about how these fractures should be treated. Anatomic reduction of the distal radius is necessary to achieve good functional results. In particular, the elderly patient, who may have to use crutches or a walker, will need a pain-free wrist under axial load. The pi plate is designed for distal radius fractures. It has been widely criticized for causing irritation and/or rupture of the extensor tendons. Most complications of the implant can be avoided with a careful operative technique. To prevent ruptures of the extensor tendon implant removal after 4 to 6 months is recommended. In osteoporotic bone the pi plate guarantees good stability with minimal postoperative loss of reduction. The operative technique is described in detail and common complications are discussed.