Results of dorsal or volar plate fixation of AO type C3 distal radius fractures: a retrospective study.

PURPOSE: The aim of this study was to define the outcome after dorsal or volar plating of Association for Osteosynthesis (AO) type C3 distal radius fractures based on the fracture morphology.

METHODS: Twenty-nine patients with AO type C3 distal radius fractures were surgically managed between 1996 and 2005. Group 1 (n = 15) had volar plating. Group 2 (n = 14) had dorsal plating. Outcomes were evaluated at an average of 22 months after surgery. Statistical analysis was performed using the Wilcoxon test and chi-square test.

RESULTS: No significant differences were seen for the scores of Gartland and Werley, Castaing, Stewart I and II, Green and O'Brien, and Disability of the Arm, Shoulder and Hand between the 2 groups. The visual and verbal pain analog scales did not show significant differences between the 2 groups. Radiology analysis showed significant difference in comparison with the contralateral side in terms of dorsopalmar inclination (3 degrees +/- 3) and distal radioulnar joint angle (98 degrees +/- 8) for the patients in group 1, whereas there were no significant differences in group 2. The development of radiographic post-traumatic arthritis was significant in both groups. Significant functional differences were seen for flexion (45 degrees +/- 15) and hand span (20 cm +/- 2) in group 1 as well as for extension (37 degrees +/- 19), flexion (42 degrees +/- 12), and radial deviation (16 degrees +/- 10) in group 2. We found more complications after dorsal plate osteosynthesis than after volar plate osteosynthesis.

CONCLUSIONS: This study shows satisfactory functional and subjective outcome results in both groups. Group 1 had non-significant better functional results than group 2, whereas both groups showed good to very good radiology results.