Fixed angle fixation permits early function after distal radius fractures. We present a treatment method that provides the benefits of this form of fixation through a minimally invasive approach.

Methods:

We reviewed retrospectively all patients treated between January 2002 and June 2003 at our center, for unstable distal radius fractures using a new fixation implant. The DNP is a fixed angle nail-plate hybrid device designed to be applied through a small dorsal incision and with minimal soft tissue disruption. Postoperative management included immediate finger motion, early functional use of the hand and a wrist splint used for an average of three weeks. Standard radiographic fracture parameters were measured and final functional results where assessed by measuring digital motion, wrist motion and grip strength.

Results:

Of 23 patients that fit the inclusion criteria, we were able to follow 20 patients with 21 unstable distal radius fractures for an average of 31 weeks. Three patients were lost to follow-up. All patients were treated as outpatients all under regional anesthesia. Final volar tilt averaged 8 deg., radial tilt 22 deg. and radial shortening averaged <1 mm. The average final dorsiflexion was 60 deg., volar flexion 45 deg., pronation 83 deg. and supination 80 deg. Grip strength was 72% of the contra-lateral side. There were no device failures or significant loss of reduction.

Conclusion:

It is possible to treat unstable distal radius fractures with fixed angle device applied through a minimally invasive approach, providing stable internal fixation and allowing early function in the elderly or infirm patient that is a poor candidate for a more extensive surgical procedure. This technique allows early return to function, provides good final results and presents a low complication rate.