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Dorsal Plating of Unstable Distal Radius Fractures Using a Bio-Absorbable Plating System and Bone SubstituteFrom the Southend Hospital, Westcliff-on-Sea, Essex, UK Correspondence: Mr S. Gangopadhyay, 108 Abbey Road, West Bridgford, Nottingham NG2 5NB, UK. Tel.: +441159235029; fax: +441702221088. E-mail: gangoss{at}aol.com This study reports the results of open reduction and internal fixation of 26 unstable, intraarticular, dorsally displaced fractures of the distal radius using a bio-absorbable dorsal distal radius (Reunite) plate and calcium phosphate (Biobon) bone substitute. The bio-absorbable plate has the advantage of being low profile, easily contourable and angularly stable. In the majority of cases, this plate produces functional results comparable with metal plates. The Gartland and Werley score was excellent or good in 21 patients. The theoretical advantage over metal plates is in eliminating the need to remove the plate and hence the need for a second operation if implant-related extensor tenosynovitis occurs. Inflammatory tissue reaction to the degradation products of the plate is a potential concern, although the co-polymer ratio used in this plate appears to have reduced the severity of this reaction, which was seen in two patients in this series. The reduction was lost in five patients with severe dorsal comminution. Following this experience, we do not recommend this plating system for fractures with a metaphyseal gap of greater than 7 mm following reduction.
Key Words: fracture • distal radius • bio-absorbable • dorsal comminution • bone substitute
Journal of Hand Surgery (British and European Volume), Vol. 31, No. 1,
93-100 (2006) |
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