Use of Miniplate for Severe Comminuted Metadiaphyseal Fractures of the Distal Radius

Abstract

Purpose: This study investigated the clinical and radiological outcomes of patients undergoing provisional fixation in conjunction with locking plate fixation. Miniplates were used as the reduction plates for the surgical treatment of severe comminuted metadiaphyseal fractures with an intra-articular fracture of the distal radius. Materials and Methods: The radial length, radial inclination, volar tilt, and radial intra-articular stepoff were measured preoperatively, postoperatively, and at one year after surgery in 12 patients (eight males, four females, mean age 55.4 years old). The patients underwent volar locking plate fixation with miniplate as a reduction plate for severe comminuted metadiaphyseal fractures with an intra-articular fracture of the distal radius. Clinical evaluations were conducted using the modified Mayo wrist score (MMWS). Results: Bone union was achieved in all cases. The mean MMWS was 81.8 points, including two excellent, three good, and seven fair cases. Radiological improvements were observed in the average radial length (preoperative, 6.4 mm; postoperative, 11.8 mm), average radial inclination (10.2° to 22.4°), average volar tilt (–4.5° to 10.6°), and average radial intra-articular step-off (4.8-0.8 mm) (all, p<0.05). Radiographic measurements obtained immediately after surgery and at the final follow-up revealed insignificant decreases in radial length (0.6 mm), radial inclination (0.4°), and volar tilt (0.9°) (all, p>0.05). Conclusion: Miniplate fixation can be an effective treatment option as a reduction plate for the treatment of distal radial fractures, which is challenging to reduce and maintain due to severely comminuted metadiaphysis fractures with the intra-articular fracture.