Open reduction and internal fixation of unstable distal radius fractures: results using the trimed fixation system.

OBJECTIVE

The purpose of this study was to evaluate the early results of patients with displaced and unstable distal radius fractures treated with fragment-specific fixation. DESIGN Prospective and consecutive.

SETTING

Private orthopaedic practice.

PATIENTS/PARTICIPANTS: Twenty-five patients with 27 fractures with an average follow-up of 29 months (range 24-36 months) treated with fragment-specific fixation for unstable radius fractures.

MAIN OUTCOME MEASUREMENTS

Clinical and radiographic examination. Disabilities of the arm, hand, and shoulder and patient-rated wrist evaluation outcome measures. RESULTS Patients had an average 61 degrees of dorsiflexion and 54 degrees of palmarflexion at the wrist. Twenty-five fractures healed in acceptable alignment, with one loss of reduction and one patient death. Mean +/- standard deviation DASH score was 17 +/- 18, and PRWE score was 19 +/- 22.

CONCLUSION

Unstable distal radius fractures can be reliably and anatomically reduced and stabilized using fragment-specific fixation. Fixation of markedly comminuted fractures is secure enough to allow immediate motion and does not require casting or external fixation. Preliminary clinical and radiographic results are excellent, and patient satisfaction is high. Anatomic reduction with early motion can be achieved in a routine fashion on unstable distal radius fractures using the described technique.