[Treatment of intra-articular fracture of distal radius with T-shaped plate internal fixation].

OBJECTIVE: To evaluate the effects of T-shaped plate internal fixation in treatment of intra-articular fracture of distal radius.

METHODS: From January 2005 to March 2008, 52 cases of intra-articular fracture of distal radius were treated, including 32 males and 20 females and aging 21-60 years old (mean 47 years old). Fracture was caused by tumbling in 30 cases, by falling from height in 8 cases, by traffic accident in 11 cases, and by a crashing object in 3 cases. Of 52 cases, there were 50 cases of closed fracture and 2 cases of open fracture. According to AO standard of classification, there were 14 cases of B2 type, 16 cases of B3 type, 15 cases of C1 type, 6 cases of C2 type, and 1 case of C3 type. According to the Cooney's general standard of classification of unstable fracture, there were 5 cases of type II, 10 cases of type III, and 37 cases of type IV. The time from injury to operation was 3-14 days (mean 5 days). All patients received open reduction and T-shaped plate fixation. Seven patients having bone defect were given 6-15 g autologous ilium or 5 mL calcium sulphate artificial aggregate after reduction.

RESULTS: All incisions healed by first intention. All the patients were followed up for 15 to 30 months postoperatively (mean 24 months). The X-ray films showed good anatomical reduction, even articular surface and no loosening of internal fixation in all the cases. The fractures healed within 9-15 weeks after operation (mean 12 weeks). At last follow-up, the mean palmar tilt was 8 degrees and the mean ulnar variance was 21 degrees, showing statistically significant differences when compared preoperation (-5 degrees and 5 degrees, P < 0.05). The radial length were not abbreviated. According to Dienst assessment, the results were excellent in 42 cases, good in 3 cases, fair in 5 cases and poor in 2 cases 12 weeks after operation, and the excellent and good rate was 86.5%.

CONCLUSION: T-shaped plate fixation is reliable and effective in treatment of intra-articular fracture of distal radius because it has less complication of infection, loosening of internal fixation, reduction failure and tendon rupture.