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. 2025 Oct;20(7):1116-1123.
doi: 10.1177/15589447241247335. Epub 2024 May 2.

What to Expect? Use of Supplemental Fixation With a Concomitant Dorsal Spanning Plate for Complex Intraarticular Distal Radius Fractures

Eric Gruenberger  1 , Elizabeth K Carlino  1 , Adam Webb  2 , Mitchell Bowers  3 , Brent Ponce  1 , Todd Rubin  4
Affiliations

What to Expect? Use of Supplemental Fixation With a Concomitant Dorsal Spanning Plate for Complex Intraarticular Distal Radius Fractures

Eric Gruenberger et al. Hand (N Y). 2025 Oct.

Abstract

Background: The dorsal spanning plate (DSP) is a versatile implant suitable for bridging severely comminuted intraarticular distal radius fractures [AO (Arbeitsgemeinschaft für Osteosynthesefragen) 23-C.1-C.3]. It may be used alone or with supplemental fixation such as a volar locking plate (VLP) or fragment-specific fixation (FSF). Outcomes following DSP fixation with additional implants have not been specifically evaluated.

Methods: We retrospectively reviewed consecutive patients who underwent internal fixation of a distal radius fracture by a single surgeon from 2017 to 2021. Patients were grouped according to implants used: DSP only, DSP + FSF, and DSP + VLP. Preoperative variables, treatment times, and wrist range of motion (ROM) were assessed. Functional wrist ROM was defined as minimum 80° combined flexion and extension.

Results: One hundred fifty-two patients underwent surgery for wrist fracture, 33 of them were treated with a DSP: 8 DSP only, 6 DSP + VLP, and 19 DSP + FSF. Falls from height greater than 10 ft accounted for 52% of injuries, most of which were treated with a DSP + FSF. Treatment times and ROM were similar between subgroups. Wrist ROM did not improve significantly beyond 4 weeks following DSP removal. Overall, DSP patients recovered a mean wrist ROM of 85° (range 0°-130°) within a median 26 weeks total treatment period (range 12-68 weeks).

Conclusion: Regardless of the construct used, if the distal radius articular surface is well reduced and other principles of fracture fixation are applied, most patients treated with a DSP can expect to regain functional wrist ROM.

Level of evidence: Level IV-Retrospective review of prospectively collected data.

Keywords: distal radius fracture; dorsal spanning plate; fragment-specific fixation; intraarticular fractures; standard volar plating.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Representative (a, b) anterior-posterior and (c, d) lateral radiographs of two patients with AO 23-C.3 distal radius fractures.
Figure 2.
Figure 2.
Representative radiographs (anterior-posterior and lateral) of (a, b) a dorsal spanning plate (DSP), (c, d) DSP + fragment-specific fixation, and (e, f) DSP + volar locking plate construct.
See this image and copyright information in PMC

References

    1. He J, Blazar P. Management of high energy distal radius injuries. Cur Rev Musculoskel Med. 2019;12(3):379-385. - PMC - PubMed
    1. Bartl C, Stengel D, Bruckner T, et al. The treatment of displaced intra-articular distal radius fractures in elderly patients. Dtsch Arztebl Int. 2014;111(46):779-787. - PMC - PubMed
    1. Zimmer J, Atwood DN, Lovy AJ, et al. Characterization of the dorsal ulnar corner in distal radius fractures in postmenopausal females: implications for surgical decision making. J Hand Surg Am. 2020;45(6):495-502. - PubMed
    1. Burke EF, Singer RM. Treatment of comminuted distal radius with the use of an internal distraction plate. Tech Hand Up Extrem Surg. 1998;2(4):248-252. - PubMed
    1. Hanel DP, Lu TS, Weil WM. Bridge plating of distal radius fractures: the harborview method. Clin Orthop Relat Res. 2006;445:91-99. - PubMed