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Review
. 2021 Nov;16(6):834-842.
doi: 10.1177/1558944719893068. Epub 2019 Dec 17.

Dorsal Wrist Spanning Plate Fixation for Treatment of Radiocarpal Fracture-Dislocations

Elizabeth P Wahl  1 , Alexander S Lauder  2 , Tyler S Pidgeon  1 , Evan M Guerrero  1 , David S Ruch  1 , Marc J Richard  1
Affiliations
Review

Dorsal Wrist Spanning Plate Fixation for Treatment of Radiocarpal Fracture-Dislocations

Elizabeth P Wahl et al. Hand (N Y). 2021 Nov.

Abstract

Background: Radiocarpal dislocations are rare injuries that result from high-energy forces across the wrist with the hallmark finding of radiocarpal ligament disruption. Published treatment methods are comprehensive with moderate-to-good outcomes. The purpose of this study was to review the treatment of radiocarpal dislocations with a dorsal wrist spanning plate. Methods: A retrospective review was conducted analyzing the radiographic and clinical outcomes of patients treated for a radiocarpal dislocation using a dorsal wrist spanning plate over a 10-year period. Outcomes assessed included radiographic joint incongruity and arthrosis, wrist range of motion, grip strength, Visual Analogue Scale (VAS) score, surgical complications, and Disabilities of the Arm, Shoulder, and Hand (DASH) score. Results: Thirteen patients were treated with a dorsal wrist spanning plate for radiocarpal dislocation with a mean follow-up of 615 days from the time of initial surgery. Six patients (46%) had associated distal radioulnar joint instability. The mean wrist range of motion at the final follow-up was: flexion 39°, extension 44°, pronation 79°, and supination 84°. One patient (8%) developed ulnar translation of the carpus, and 11 patients (85%) developed radiographic posttraumatic wrist arthrosis. Mean VAS and DASH scores were 4 and 18, respectively. Conclusions: Acute treatment with a dorsal wrist spanning plate in this series resulted in comparable outcomes to what have been previously reported in the literature. The dorsal wrist spanning plate offers the surgeon a reliable method of stabilization, with minimal additional surgical trauma to the wrist, while avoiding the potential for infections that develop with other treatment methods.

Keywords: diagnosis; fracture/dislocation; radiocarpal; research and health outcomes; specialty; surgery; trauma; treatment; wrist.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Author David S. Ruch receives intellectual property rights from and is a paid presenter for Acumed and is on a committee for the American Society for Surgery of the Hand and is on the board for the American Association for Hand Surgery. Author Marc J. Richard is a consultant for Acumed, DJO, Medartis, and Synthes; a paid presenter for Bioventus; and is on a committee for the American Society for Surgery of the Hand.

Figures

Figure 1.
Figure 1.
Flowchart of the study selection process. Note. ICD-9 = International Classification of Diseases, Ninth Revision; ICD-10 = International Classification of Diseases, Tenth Revision; CPT = Current Procedural Terminology.
Figure 2.
Figure 2.
(a) Anteroposterior (AP) and (b) lateral radiographs show a dorsal Dumontier type I and Moneim type I radiocarpal fracture-dislocation with an ulnar styloid fracture. (c) AP and (d) lateral radiographs show treatment with a dorsal wrist spanning plate. (e) AP and (f) lateral radiographs demonstrate status after removal of dorsal wrist spanning plate and evidence of radiocarpal arthrosis and an ulnar styloid nonunion.
See this image and copyright information in PMC

References

    1. Dunn AW. Fractures and dislocations of the carpus. Surg Clin North Am. 1972;52(6):1513-1538. - PubMed
    1. Ilyas AM, Williamson C, Mudgal CS. Radiocarpal dislocation: is it a rare injury? J Hand Surg Eur Vol. 2011;36(2):164-165. - PubMed
    1. Mayfield JK, Johnson RP, Kilcoyne RK. Carpal dislocations: pathomechanics and progressive perilunar instability. J Hand Surg Am. 1980;5(3):226-241. - PubMed
    1. Moneim MS, Bolger JT, Omer GE. Radiocarpal dislocation—classification and rationale for management. Clin Orthop Relat Res. 1985;192:199-209. - PubMed
    1. Dumontier C, Meyer zu, Reckendorf G, Sautet A, et al.. Radiocarpal dislocations: classification and proposal for treatment. A review of twenty-seven cases. J Bone Joint Surg Am. 2001;83(2):212-218. - PubMed