Comparison of radiographic and functional outcomes of dorsal-only versus combined volar/dorsal plating in AO type C distal radius fracture.

Abstract

Introduction: Distal radius fractures are commonly treated with open reduction and internal fixation, especially in younger adults. This study aims to compare the radiographic and functional outcomes, as well as complications, of dorsal-only plating versus combined volar/dorsal plating in treating AO type C distal radius fractures.

Methods: This retrospective study included 18 patients with AO type C distal radius fractures, treated between 2021 and 2024. Patients were divided into two groups: Group A (12 patients) underwent dorsal-only plating, while Group B (six patients) received combined volar/dorsal plating. Radiographic assessments included radial inclination, radial height, palmar tilt, and ulnar variance. Clinical outcomes, including wrist range of motion, grip strength, Quick DASH, and Mayo Wrist Scores, were evaluated. Complications such as extensor tendon irritation, implant removal, and reflex sympathetic dystrophy were documented.

Results: Radiographic outcomes were similar between the groups, with no significant differences in radial alignment or joint integrity. Both groups showed significant improvement in joint alignment from preoperative to postoperative evaluations. Clinically, grip strength was significantly higher in Group A (p = 0.037), though wrist range of motion and functional scores (Quick DASH and Mayo Wrist Score) showed no significant differences. Group B exhibited a higher complication rate, including compartment syndrome and reflex sympathetic dystrophy.

Conclusion: Dorsal-only plating for AO type C distal radius fractures yields comparable radiographic and functional outcomes to combined volar/dorsal plating, with a lower incidence of complications. This approach may offer a functional advantage in terms of grip strength, and reduced implant-related complications suggest it as a viable treatment option. Further prospective studies are recommended to confirm these findings.