Fragment-specific fracture fixation and double-column plating of unstable distal radial fractures using AO mini-fragment implants and Kirschner wires

SummaryObjectiveTo evaluate the efficacy of AO mini-fragment implants and 1.25-mm Kirschner wires using fragment-specific fracture fixation and double-column plating for displaced or unstable distal radial fractures.MethodsDesign: prospective and consecutive. Setting: level II trauma hospital. Participants: 28 people with 30 fractures and an average follow-up of 21.1 (range 12–41) months, treated with fragment-specific fracture fixation. Outcome measurements: anatomical assessment using anteroposterior and lateral radiographs, graded according to Sarmiento's modification of Lidstrom's scoring system. Clinical outcome assessment: DASH and Modified Gartland and Werley scores.ResultsThere were 24 excellent and 6 good radiological results. Final mean grip strength was 83% of uninjured side, and mean wrist range of motion was 61° dorsiflexion, 54° palmar flexion, 85° supination and 83° pronation. Gartland and Werley's demerit point system revealed 13 (43%) excellent, 12 (40%) good, 5 (17%) fair and no poor results. The mean DASH score was 18, with a standard deviation of ±18.ConclusionThis fixation method is a reliable and low-cost alternative with good clinical and anatomical results, particularly useful in open reduction and internal fixation of comminuted intra-articular distal radial fractures.