Skip to main content

Temporary spanning plate wrist fixation of complex distal radius fractures: a systematic review of 353 patients

Abstract

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.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

References

  1. Sa-Ngasoongsong P, Rohner-Spengler M, Delagrammaticas DE, Babst RH, Beeres FJP. Comparison of fracture healing and long-term patient-reported functional outcome between dorsal and volar plating for AO C3-type distal radius fractures. Eur J Trauma Emerg Surg. 2019. https://doi.org/10.1007/s00068-019-01100-w.

    Article  PubMed  Google Scholar 

  2. Mellstrand Navarro C, Ahrengart L, Törnqvist H, Ponzer S. Volar locking plate or external fixation with optional addition of k-wires for dorsally displaced distal radius fractures. J Orthop Trauma. 2016;30:217–24. https://doi.org/10.1097/BOT.0000000000000519.

    Article  PubMed  Google Scholar 

  3. Hammer O-L, Clementsen S, Hast J, Šaltytė Benth J, Madsen JE, Randsborg P-H. Volar locking plates versus augmented external fixation of intra-articular distal radial fractures: functional results from a randomized controlled trial. J Bone Jt Surg Am. 2019;101:311–21. https://doi.org/10.2106/JBJS.18.00014.

    Article  Google Scholar 

  4. Gouk CJC, Bindra RR, Tarrant DJ, Thomas MJE. Volar locking plate fixation versus external fixation of distal radius fractures: a meta-analysis. J Hand Surg (Eur Vol). 2017;0:1753–934. https://doi.org/10.1177/1753193417743936.

    Article  Google Scholar 

  5. Burke EF, Singer RM. Treatment of comminuted distal radius with the use of an internal distraction plate. Tech Hand Up Extrem Surg. 1998;2:248–52.

    CAS  Article  Google Scholar 

  6. Ruch DS, Ginn TA, Yang CC, Smith BP, Rushing J, Hanel DP. Use of a distraction plate for distal radial fractures with metaphyseal and diaphyseal comminution. J Bone Jt Surg. 2005;87:945–54.

    Article  Google Scholar 

  7. Hanel DP, Lu TS, Weil WM. Bridge plating of distal radius fractures: the Harborview method. Clin Orthop Relat Res. 2006;445:91–9. https://doi.org/10.1097/01.blo.0000205885.58458.f9.

    Article  PubMed  Google Scholar 

  8. Hanel DP, Ruhlman SD, Katolik LI, Allan CH. Complications associated with distraction plate fixation of wrist fractures. Hand Clin. 2010;26:237–43. https://doi.org/10.1016/j.hcl.2010.01.001.

    Article  PubMed  Google Scholar 

  9. Richard MJ, Katolik LI, Hanel DP, Wartinbee DA, Ruch DS. Distraction plating for the treatment of highly comminuted distal radius fractures in elderly patients. J Hand Surg Am. 2012;37:948–56. https://doi.org/10.1016/J.JHSA.2012.02.034.

    Article  PubMed  Google Scholar 

  10. Jain MJ, Mavani KJ. A comprehensive study of internal distraction plating, an alternative method for distal radius fractures. J Clin Diagnostic Res. 2016;10:RC14–7. https://doi.org/10.7860/JCDR/2016/21926.9036.

    Article  Google Scholar 

  11. Dodds SD, Save AV, Yacob A. Dorsal spanning plate fixation for distal radius fractures. Tech Hand Up Extrem Surg. 2013;17:1–7.

    Article  Google Scholar 

  12. Hyatt BT, Hanel DP, Saucedo JM. Bridge plating for distal radius fractures in low-demand patients with assist devices. J Hand Surg Am. 2019;44:507–13. https://doi.org/10.1016/j.jhsa.2018.08.014.

    Article  PubMed  Google Scholar 

  13. Potter MQ, Haller JM, Tyser AR. Ligamentous radiocarpal fracture-dislocation treated with wrist-spanning plate and volar ligament repair. J Wrist Surg. 2014;3:265. https://doi.org/10.1055/S-0034-1394134.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Wahl EP, Lauder AS, Pidgeon TS, Guerrero EM, Ruch DS, Richard MJ. Dorsal wrist spanning plate fixation for treatment of radiocarpal fracture-dislocations. Hand (N Y). 2019. https://doi.org/10.1177/1558944719893068.

    Article  Google Scholar 

  15. Tinsley BA, Ilyas AM. Distal radius fractures in a functional quadruped: spanning bridge plate fixation of the wrist. Hand Clin. 2018;34:113–20. https://doi.org/10.1016/j.hcl.2017.09.012.

    Article  PubMed  Google Scholar 

  16. Huish EG, Coury JG, Ibrahim MA, Trzeciak MA. Radiographic outcomes of dorsal distraction distal radius plating for fractures with dorsal marginal impaction. Hand (N Y). 2018. https://doi.org/10.1177/1558944717704514.

    Article  Google Scholar 

  17. Lauder A, Agnew S, Bakri K, Allan CH, Hanel DP, Huang JI. Functional outcomes following bridge plate fixation for distal radius fractures. J Hand Surg Am. 2015;40:1554–62. https://doi.org/10.1016/j.jhsa.2015.05.008.

    Article  PubMed  Google Scholar 

  18. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097. https://doi.org/10.1371/journal.pmed.1000097.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Agoritsas T, Merglen A, Courvoisier DS, Combescure C, Garin N, Perrier A, et al. Sensitivity and predictive value of 15 PubMed search strategies to answer clinical questions rated against full systematic reviews. J Med Internet Res. 2012;14:e85. https://doi.org/10.2196/jmir.2021.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Institute of Health Economics (IHE). Quality Appraisal of Case Series Studies Checklist. Edmonton (AB): Institute of Health Economics; 2014. http://www.ihe.ca/research-programs/rmd/cssqac/cssqac-about. Accessed 5 Nov 2020

  21. Beeres FJP, Liechti R, Link B-C, Babst R. Role of a spanning plate as an internal fixator in complex distal radius fractures. Oper Orthop Traumatol. 2020. https://doi.org/10.1007/s00064-020-00686-4.

    Article  PubMed  Google Scholar 

  22. Meinberg E, Agel J, Roberts C, Karam M, Kellam J. Fracture and dislocation classification compendium—2018. J Orthop Trauma. 2018;32:S1-10. https://doi.org/10.1097/BOT.0000000000001063.

    Article  PubMed  Google Scholar 

  23. Whelan DB, Bhandari M, McKee MD, Guyatt GH, Kreder HJ, Stephen D, et al. Interobserver and intraobserver variation in the assessment of the healing of tibial fractures after intramedullary fixation. J Bone Jt Surg Br. 2002. https://doi.org/10.1302/0301-620X.84B1.11347.

    Article  Google Scholar 

  24. Wilson J. Surveillance of surgical site infection in orthopaedic surgery is useful in tackling hospital-acquired infections in England. Euro Surveill. 2005. https://doi.org/10.2807/ESW.10.46.02835-EN.

    Article  PubMed  Google Scholar 

  25. Keats T, Sistrom C. Atlas of Radiologic Measurement. Philadelphia: Gulf Professional Publishing; 2001.

    Google Scholar 

  26. Greenspan A. Orthopedic radiology: a practical approach. Philadelphia: JB Lippincott; 1988.

    Google Scholar 

  27. Hanel DP, Jones MD, Trumble TE. Wrist fractures. Orthop Clin N Am. 2002;33:35–57. https://doi.org/10.1016/S0030-5898(03)00071-3.

    Article  Google Scholar 

  28. Berquist T. Imaging of Orthopedic Trauma. New York, NY: Raven Press; 1992.

    Google Scholar 

  29. Higgins J, Thomas J, Chandler J, Cumpston M, Li T, Page M, et al. Cochrane Handbook for Systematic Reviews of Interventions version 6.1 (updated September 2020). Cochrane 2020. https://training.cochrane.org/cochrane-handbook-systematic-reviews-interventions#how-to-cite. Accessed 21 Oct 2020.

  30. Wang WL, Ilyas AM. Dorsal bridge plating versus external fixation for distal radius fractures. J Wrist Surg. 2020;09:177–84. https://doi.org/10.1055/s-0039-1694063.

    Article  Google Scholar 

  31. Perlus R, Doyon J, Henry P. The use of dorsal distraction plating for severely comminuted distal radius fractures: a review and comparison to volar plate fixation. Injury. 2019;50:50–5. https://doi.org/10.1016/j.injury.2019.03.052.

    Article  Google Scholar 

  32. Huang JI, Peterson B, Bellevue K, Lee N, Smith S, Herfat S. Biomechanical assessment of the dorsal spanning bridge plate in distal radius fracture fixation: implications for Immediate weight-bearing. Hand (N Y). 2018;13:336–40. https://doi.org/10.1177/1558944717701235.

    Article  Google Scholar 

  33. Yuan BJ, Dennison DG, Elhassan BT, Kakar S. Outcomes after radiocarpal dislocation: a retrospective review. Hand. 2015;10:367–73. https://doi.org/10.1007/s11552-014-9736-5.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Trickett RW. Letter to the editor Re: The use of dorsal distraction plating for severely comminuted distal radius fractures: a review and comparison to volar plate fixation by R. Perlusa, J. Doyona and P. Henry. Injury 2019;50:1405. https://doi.org/10.1016/j.injury.2019.05.013.

  35. Pryce JC. The wrist position between neutral and ulnar deviation that facilitates the maximum power grip strength. J Biomech. 1980;13:505–11. https://doi.org/10.1016/0021-9290(80)90343-7.

    CAS  Article  PubMed  Google Scholar 

  36. Hazelton FT, Smidt GL, Flatt AE, Stephens RI. The influence of wrist position on the force produced by the finger flexors. J Biomech. 1975;8:301–6. https://doi.org/10.1016/0021-9290(75)90082-2.

    CAS  Article  PubMed  Google Scholar 

  37. Alluri RK, Bougioukli S, Stevanovic M, Ghiassi A. A biomechanical comparison of distal fixation for bridge plating in a distal radius fracture model. J Hand Surg Am. 2017;42:748.e1-748.e8. https://doi.org/10.1016/j.jhsa.2017.05.010.

    Article  Google Scholar 

  38. Guerrero EM, Lauder A, Federer AE, Glisson R, Richard MJ, Ruch DS. Metacarpal position and lunate facet screw fixation in dorsal wrist-spanning bridge plates for intra-articular distal radial fracture: a biomechanical analysis. J Bone Jt Surg Am. 2020;102:397–403. https://doi.org/10.2106/JBJS.19.00769.

    Article  Google Scholar 

  39. Margaliot Z, Haase SC, Kotsis SV, Kim HM, Chung KC. A meta-analysis of outcomes of external fixation versus plate osteosynthesis for unstable distal radius fractures. J Hand Surgery Am Vol. 2005. https://doi.org/10.1016/J.JHSA.2005.08.009.

    Article  Google Scholar 

  40. Zollinger PE, Kreis RW, van der Meulen HG, van der Elst M, Breederveld RS, Tuinebreijer WE. No higher risk of CRPS after external fixation of distal radial fractures—subgroup analysis under randomised vitamin C prophylaxis. Open Orthop J. 2010;4:71–5. https://doi.org/10.2174/1874325001004020071.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Roh YH, Lee BK, Noh JH, Baek JR, Oh JH, Gong HS, et al. Factors associated with complex regional pain syndrome type I in patients with surgically treated distal radius fracture. Arch Orthop Trauma Surg. 2014;134:1775–81. https://doi.org/10.1007/s00402-014-2094-5.

    Article  PubMed  Google Scholar 

  42. Graham TJ. Surgical correction of malunited fractures of the distal radius. J Am Acad Orthop Surg. 1997;5:270–81. https://doi.org/10.5435/00124635-199709000-00005.

    CAS  Article  PubMed  Google Scholar 

  43. Gartland JJ, Werley CW. Evaluation of healed colles’ fracture. J Bone Jt Surg. 1951;33:895–907.

    Article  Google Scholar 

  44. Nana AD, Joshi A, Lichtman DM. Plating of the distal radius. J Am Acad Orthop Surg. 2005;13:159–71. https://doi.org/10.5435/00124635-200505000-00003.

    Article  PubMed  Google Scholar 

  45. Prommersberger KJ, Pillukat T, Mühldorfer M, Van Schoonhoven J. Malunion of the distal radius. Arch Orthop Trauma Surg. 2012;132:693–702. https://doi.org/10.1007/s00402-012-1466-y.

    Article  PubMed  Google Scholar 

  46. Hodel S, Schraner C, Oehme F, van Leeuwen R, Link BC, Babst R, et al. Factors predicting adverse outcome in complete intra-articular distal radius fractures. Eur J Trauma Emerg Surg. 2019. https://doi.org/10.1007/s00068-019-01102-8.

    Article  PubMed  Google Scholar 

  47. Ikpeze TC, Smith HC, Lee DJ, Elfar JC. Distal radius fracture outcomes and rehabilitation. Geriatr Orthop Surg Rehabil. 2016;7:202–5. https://doi.org/10.1177/2151458516669202.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Shauver MJ, Chang KWC, Chung KC. Contribution of functional parameters to patient-rated outcomes after surgical treatment of distal radius fractures. J Hand Surg Am. 2014;39:436–42. https://doi.org/10.1016/j.jhsa.2013.11.015.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Wilcke MKT, Abbaszadegan H, Adolphson PY. Patient-perceived outcome after displaced distal radius fractures. A comparison between radiological parameters, objective physical variables, and the DASH score. J Hand Ther. 2007;20:290–9. https://doi.org/10.1197/j.jht.2007.06.001.

    Article  PubMed  Google Scholar 

  50. Iselin LD, Massy-Budmiger AS, Droeser RA, Mett TR, Babst R, Rikli DA. Ten years’ follow-up on combined palmar and dorsal internal fixation of complex distal radius fractures. Med (United States). 2016;95:e3509. https://doi.org/10.1097/MD.0000000000003509.

    Article  Google Scholar 

Download references

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rémy Liechti.

Ethics declarations

Conflict of interest

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Beeres, F.J.P., van de Wall, B.J.M., Hug, U. et al. Temporary spanning plate wrist fixation of complex distal radius fractures: a systematic review of 353 patients. Eur J Trauma Emerg Surg 48, 1649–1662 (2022). https://doi.org/10.1007/s00068-021-01656-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00068-021-01656-6

Keywords

  • Distal radius fracture
  • Spanning plate
  • Bridge plate