Outcomes after volar plate fixation of low-grade open and closed distal radius fractures are similar

Abstract

Background: Low-grade (Gustilo and Anderson Type I or II) open distal radius fractures (DRFs) have been treated by volar locking plate fixation. However, it is unclear whether the outcomes after volar locking plate fixation for low-grade open DRFs are comparable to those for closed DRFs. Questions/purposes: We asked whether low-grade open DRFs had worse DASH scores and higher infection rates than closed DRFs when the DRFs were treated by volar plate fixation. Methods: Twenty consecutive patients treated by volar locking plate fixation for low-grade open DRFs constituted the open fracture group, and 40 patients were selected from among the total number of patients treated by volar, locking plate fixation for closed DRFs as the closed fracture group. Complications including infection were recorded. Clinical outcomes and radiographic assessments were performed postoperatively at 3 months and 1 year. Results: At 3 postoperative months, wrist flexion and extension, grip strengths, and DASH scores were better in the closed fracture group; however, no difference was observed postoperatively between the two groups in terms of any functional outcome measure at 1 year. Any of the radiographic parameters were not different between the groups. There were no differences in infection rate and in any other complication rate between the groups. Conclusions: Although functional outcomes of open DRFs were inferior to those of closed DRFs at 3 months, at 1 year, outcomes of low-grade open DRFs were found to be comparable to those of closed DRFs when volar plate fixation was used. Level of Evidence: Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence. © 2013 The Association of Bone and Joint Surgeons®.