Purpose
Previous studies evaluating weight bearing of distal radius fractures treated through
dorsal spanning bridge plates used extra-articular fracture models, and have not evaluated
the role of supplementary fixation. We hypothesized that supplementary fixation with
a spanning dorsal bridge plate for an intra-articular wrist fracture would decrease
the displacement of individual articular pieces with cyclic axial loading and allow
for walker or crutch weight bearing.
Methods
Thirty cadaveric forearms were matched into 3 cohorts, controlling for age, sex, and
bone mineral density. An intra-articular fracture model was fixed with the following
3 techniques: (1) cohort A with a dorsal bridge plate, (2) cohort B with a dorsal
bridge plate and two 1.6-mm k-wires, and (3) cohort C with a dorsal bridge plate and
a radial pin plate. Specimens were axially loaded cyclically with escalating weights
consistent with walker and crutch weight-bearing with failure defined as 2-mm displacement.
Results
No specimens failed at 2- or 5-kg weights, but cohort A had significantly more displacement
at these weights compared with cohort B. Cohort A had significantly more failure than
cohort C. Both cohort A and cohort B had significantly more displacement at crutch
weight bearing compared with cohort C. The supplementary fixation group had significantly
lower displacement at crutch weight-bearing compared with cohort A in all gaps. Survival
curves demonstrated the fixation cohort to survive higher loads than the nonfixation
group.
Conclusion
There was significantly less displacement and less failure of intra-articular distal
radius fractures treated with a spanning dorsal bridge plate and supplementary fixation.
Our model showed that either type of fixation was superior to the nonfixation group.
Clinical Significance
When considering early weight-bearing for intra-articular distal radius fractures
treated with a spanning dorsal bridge plate, supplementary fixation may be considered
as an augmentation to prevent fracture displacement.
Key words
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Article info
Publication history
Published online: February 13, 2023
Accepted:
January 4,
2023
Received:
August 11,
2022
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly to this article.
Identification
Copyright
© 2023 by the American Society for Surgery of the Hand. All rights reserved.
