Does Weightbearing Affect Radiographic or Clinical Outcomes in Distal Radius Fractures Treated With Dorsal Bridge Plate Fixation?

Background: Dorsal wrist spanning plate (DWSP) fixation in distal radius fractures (DRFs) has been proposed to allow earlier mobilization in polytraumatized patients by enabling early weightbearing (WB) through the injured wrist. The purpose of this study is to compare radiographic and clinical outcomes in patients who bore weight through the injured wrist within the early postoperative period with patients who did not bear weight.

Methods: Patients who underwent DWSP fixation at a single institution were retrospectively identified. Patients who bore weight through the injured wrist for purposes of assisted ambulation (WB) were identified and compared with patients who did not bear weight through the injured wrist (non-weightbearing [NWB]). Outcomes included complication rates, radiographic measurements, visual analogue scale (VAS) pain scores, and range of motion.

Results: In total, 123 patients underwent DWSP fixation for DRF between 2005 and 2018, including 30 in the WB cohort and 93 in the NWB cohort. There was no significant difference in patient age, sex, or injury to dominant extremity. The WB group had longer duration of DWSP before removal (121 ± 26.2 vs 106.3 ± 29.5 days, P = .02). There was no significant difference in complication rates (13.3% vs 16.1%, P = .71), clinical outcomes (VAS, flexion, extension, pronosupination), or radiographic parameters preoperatively, postoperatively, after plate removal, or at final follow-up.

Conclusions: Early WB through the injured wrist appears to be safe in patients with DRFs treated with DWSP. There were no significant differences in outcomes or complications between patients treated with DWSP based on WB status postoperatively.

Level of evidence: Retrospective cohort, Level III.