Is an implant removal after dorsal plating of distal radius fracture always needed?

Abstract

Purpose: The purpose of this study was to evaluate the need for an implant removal and the frequency of hardware related complications in a group of distal radius fractures treated with dorsal double plating.

Methods: This retrospective study analyzed data from 37 patients in whom distal radius fracture surgery was performed through single dorsal approach with two low profile titanium plates during a period of 5 years. Objective and subjective parameters were evaluated, focusing on detection of potentially harmful complications and the need of hardware removal during the follow up at least 12 months after the surgery.

Results: 37 patients with distal radius fracture treated by dorsal double plating were included in this study. 19 patients had their implant removed and 18 patients had their implant retained. There was no statistical difference between these groups in respect to age, fracture type, incidence of associated wrist injury, hand dominance, gender and Mayo wrist score. Only subjective parameters including the average value of the Quick Disabilities of Arm, Hand, and Shoulder Questionnaire and the Visual Analogue Scale were higher in the group of patient requiring implant removal with a statistically significant difference.

Conclusion: Our results suggested that only symptomatic hardware should be removed. A decreased range of motion and extensor tendon problems are the most frequent complication, that necessitate plate removal. The main indicator of implant related soft tissue problems was the dorsal wrist pain syndrome (Tab. 1, Fig. 3, Ref. 36). Text in PDF www.elis.sk.

Keywords: distal radius fracture; dorsal plates; implant removal..