[Is the locking, 3.5 mm Palmar T-Plate the implant of choice for displaced distal radius fractures?].

BACKGROUND

There are many different possibilities for the treatment of the distal radial fracture. According to evidence-based medicine there is no gold standard for the treatment of this fracture. With the development of locking plates, the spectrum of indications for plate osteosynthesis has possibly increased. The aim of our investigation was the evaluation of the clinical results after stabilisation of distal radial fractures with the locking, 3.5 mm T-LCP.

MATERIAL AND

METHODS

In a retrospective study we analysed all patients with distal radial fractures treated with a 3.5 mm T-LCP between 05/02 and 05/04. The complete medical histories and X-rays were analysed and a clinical follow-up examination with the Martini score was performed.

RESULTS

76 from 93 patients (82%) could be examined for the follow-up, the average age was 59 years (17/88). According to the AO classification of Mueller and Nazarian we had 23 A-fractures, 7 B-fractures and 73 C-fractures. After reduction and plate osteosynthesis we found no secondary displacement. The median of the overall results according to the Martini score was 33 from 38 points (9/38). As far as complications were found 1 CRPS, 3 CTS, 2 pseudarthroses, 1 wound infection, 1 delayed bony union, 3 implant failures, and 1 broken plate (after a new injury). In one case the median nerve was cut during operation and a suture was performed.

CONCLUSION

According to our results the 3.5 mm T-LCP is a good implant for the stabilisation of displaced distal radius fractures if the fragments are not too small for the 3.5 mm screws. The anatomic reduction is maintained and the X-rays show very good results. Compared with other investigations we must ask ourselves if the benefit of the locking plates justifies its use as compared with non-locking (conventional) plates.