Jong Hun BAEK, Jae Hoon LEE, Jung Tae AHN

Dorsal plating versus volar plating with limited dorsal open reduction in the management of AO type C3 distal radius fractures with impacted articular fragments: A retrospective comparative study

Objective: The aim of this study was to compare the outcomes of dorsal plating versus volar plating with limited dorsal open reduction in the management of AO type C3 distal radius fractures with impacted articular fragments. Methods: Thirty patients who underwent dorsal plating (Group A) (14 females, 16 males; mean age = 56.8 ± 10.1 years) and 28 who underwent volar plating with limited dorsal open reduction (Group B) (12 females, 16 males; mean age = 55.6 ± 17.7 years) for type C3 distal radius fractures with impacted articular fragments between 2006 and 2019 were retrospectively analyzed. The mean follow-up was 14.5 ± 3.2 months in group A and 13.2 ± 2.4 months in group B. The articular step-off, articular gap and joint penetration by screws on the computed tomography scans were used for radiologic evaluation. The functional outcomes were evaluated with range of motion, grip power, Quick Disabilities of the Arm, Shoulder, and Hand (DASH) score, and Mayo wrist score. Results: No significant difference was found in the step-off distance at 1 year after surgery between the two groups (P < 0.05). The ranges of extension, rotation, and radial and ulnar deviations did not differ between the groups. However, group B had a significantly higher range of flexion in the wrist joint than Group A (P = 0.010). The grip power, DASH score, and Mayo wrist score did not also differ between the groups. Implant removal owing to any discomfort at the operative site was performed in 15 patients (63%) in Group A and 7 patients (28%) in Group B. Conclusion: Similar clinical results can be obtained by both dorsal plating and volar plating with limited dorsal open reduction in treating type C3 distal radius fractures with impacted articular fragments. However, volar plating with limited dorsal open reduction can provide better wrist flexion with a low incidence of complications associated with implantation.

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