Early Removal of Dorsal Spanning Plate With Supplemental Distal Radius Fixation: Safety and Efficacy

The purpose of the study was to evaluate the safety and efficacy of early dorsal spanning plate (DSP) removal at 6-9 weeks in the management of distal radius fractures.

A retrospective review of adult patients (≥18years) treated with DSP with or without supplemental volar plate fixation for unstable distal radius fractures between January 2019 and December 2022 was conducted. Inclusion criteria included DSP removal 6-9 weeks after surgery and a minimum of the 12-month follow-up. Patients were excluded if they had previous ipsilateral hand, wrist, or forearm surgery or incomplete records. Demographics, perioperative details, and radiographic measurements were collected (before surgery, immediate after surgery, immediately following DSP removal, and at the most recent follow-up). Functional outcomes were assessed using the quick disabilities of the arm, shoulder, and hand questionnaire.

Seventeen patients were included (mean age: 53.3 ± 21.7 years, body mass index: 27.1 ± 4.2 kg/m²). The average time to DSP removal was 6.97 ± 1.1weeks. The 2R3C3.2 AO/OTA classification was the most commonly observed fracture pattern (59%). Radiographic assessments indicated sustained anatomic alignment and fracture healing. The mean short-term quick disabilities of the arm, shoulder, and hand score was 18.9, indicating mild disability. Complications within 90 days and at the 1-year follow-up were observed in 18% and 29% of the patients, respectively, predominantly because of paresthesia and superficial wound issues.

This study confirmed the safety and efficacy of DSP removal at 6-9 weeks, with clinical outcomes comparable with traditional 12-week to 16-week timelines. Future studies could evaluate whether earlier plate retrieval allows for an accelerated rehabilitation protocol, an earlier return-to-work timeline, as well as its potential in reducing postoperative stiffness.

Therapeutic IV.