Pronator sparing plate osteosynthesis in distal radius fractures: early functional outcome

Thanks to modern anatomic stable angle plate and screw designs in distal radius fractures, early mobilization is possible and pronation torque of the wrist is more important in early recovery. Pronator sparing plate osteosynthesis of the distal radius is a relatively new approach. A short overview of the technique is given with some tips and tricks. The objective of the study is to investigate whether pronator sparing approach to distal radius fractures gives better pronation force or grip force in the postoperative rehabilitation. Two randomly assigned groups of 30 patients with dorsally displaced unstable wrist fractures, operated with or without pronator sparing plate osteosynthesis, were retrospectively evaluated. Early postoperative grip force, pronator force and swelling were compared to the contralateral side. The pronator force on 3 weeks and 6 weeks was significantly higher in the "pronator sparing" group, respectively 57% and 80% of the contralateral side compared with 43% and 67% in the "non sparing" group. Also swelling was significant less in the pronator sparing group. There was no significant difference in grip force between the two groups. Pronator sparing plate osteosynthesis in distal radius fractures seems to give better pronation force and less swelling in early recovery after volar plate osteosynthesis. This technique seems not to have beneficial results on grip force.