Temporary spanning plate wrist fixation of complex distal radius fractures: a systematic review of 353 patients
Frank J P Beeres1, Bryan J M van de Wall1, Urs Hug2
1Department of Orthopedic and Trauma Surgery, Cantonal Hospital of Lucerne, Lucerne, Switzerland.
Purpose:
Temporary spanning plate fixation of the wrist has been described as an alternative treatment method for complex distal radius fractures (DRfs). This systematic review aims to gain insight on clinical and radiological outcomes of this technique currently published in literature.
Methods:
A comprehensive literature search of Pubmed, Embase, CENTRAL and CINAHL databases was conducted on November 5th 2020. All studies reporting on complications, functional, patient-rated and radiological outcomes of temporary spanning plate wrist fixation of DRFs in adult patients were included.
Results:
Two prospective and eight retrospective cohort studies were included encompassing 353 patients with of 357 DRFs. The overall mean age was 53 years (range 19-95 years). Overall mean follow-up ranged from 6 months to 8.8 years. The union rate was 99.4%. Plate removal was performed on average 4.5 months after initial operation (range 1.1-28.9 months). The most frequently reported complication was implant failure with an incidence of 3.1%. Mean flexion/extension, pronation/supination and radial/ulnar inclination arc averaged 96.6°, 151.5° and 36.5°, respectively. Grip strength averaged 79.7% of the contralateral side. Mean DASH and PRWE scores were 22.9 and 16 points, respectively. Radiological indices were all within the acceptable limits.
Conclusions:
Temporary spanning plate wrist fixation is a safe method for the treatment of complex DRFs. This technique can exploit the advantages of temporary wrist immobilization without the disadvantages of external fixation. With these aspects in mind, the spanning plate can serve as a valuable tool in the treatment of complex intra-articular DRFs.
