Complications of Radial Column Plating of the DistalRadius

摘要

Background: Distal radius fractures treated with open reduction andinternal fixation are commonly stabilized with a volar locking plate; however,more complex fracture patterns may require supplemental fixation withfragment-specific implants. The objective of this study was to evaluate theoutcomes of distal radius fractures treated with radial column plates.Methods: A consecutive series of 61 patients who sustaineddistal radius fractures underwent radial column plating alone or in conjunctionwith other implants between August 2006 and January 2014. Thirty-one patientsreturned for follow-up or returned a mailed questionnaire at an average of 4.1years. The outcomes measures included Visual Analog Scale (VAS); Disabilities ofthe Arm, Shoulder and Hand (DASH); and Patient-Rated Wrist Evaluation (PRWE)scores. Results: Sixty-one patients with a mean age of 55 years(range, 20-87) met inclusion criteria and were available for follow-up or chartreview at an average of 5.2 years (range, 1.6-9.0 years). Seventeen of 61 (28%)underwent radial column plate removal. Twenty patients returned for finalfollow-up examination, and 11 completed questionnaires via mail. Subjectivescores included a mean postoperative VAS of 0.72, DASH score of 17.2, and PRWEscore of 15.7. Hardware sensitivity and wrist stiffness were the most commoncomplications at final follow-up. Conclusions: Radial columnplating of the distal radius is a safe treatment modality and a valuable adjunctin the setting of complex distal radius fractures, but patients should becounseled that there is a 28% chance that hardware removal may be required. Ourretrospective review found evidence of few complications and objective scoresconsistent with return to normal function.