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Complications following palmar plate fixation of distal radius fractures: a review of 665 cases

P Esenwein, J Sonderegger, J Gruenert, Birte Ellenrieder, J Tawfik & M Jakubietz

abstract

INTRODUCTION
Palmar plate fixation of unstable distal radial fractures is quickly becoming the standard treatment for this common injury. The literature reporting complications consists mainly of isolated case reports or small case series.

METHOD
Between February 2004 and December 2009 palmar plate fixation was performed in 665 cases. The overall complication rate was 11.3 % (75 complications). Revision surgery was necessary in 10 % (65 procedures).

RESULTS
The reasons for revision surgery were: postoperative median nerve compression (22 patients) and secondary dislocation (9 patients). An ulna shortening osteotomy for ulnar impingement syndrome was necessary in eight cases. Intraarticular screw placement occurred in three patients. There were two flexor pollicis longus, one finger flexor and three extensor pollicis longus tendon ruptures. Posttraumatic compartment syndrome of the forearm requiring fasciotomy occurred in four cases. There were three cases of infection. Nonoperative treatment was necessary in nine patients, who developed a complex regional pain syndrome. Hardware failure occurred in three cases. Hardware removal was performed in 232 (34 %) cases.

CONCLUSION
Palmar plate fixation of distal radius fractures is a safe and effective procedure. Nevertheless, complications necessitating a second intervention are relatively common. A proportion of these complications is iatrogenic and can be avoided by improving the surgical technique.
   
citation Esenwein P, Sonderegger J, Gruenert J, ellenrieder b, Tawfik J, Jakubietz M. Complications following palmar plate fixation of distal radius fractures: a review of 665 cases. Arch Orthop Trauma Surg 2013; 133:1155-62.
   
type journal paper/review (English)
date of publishing 10-05-2013
journal title Arch Orthop Trauma Surg (133/8)
ISSN electronic 1434-3916
pages 1155-62
PubMed 23660964
DOI 10.1007/s00402-013-1766-x