The Operative Treatment of Intraarticular Smith Fractures

Abstract

Twenty-one intraarticular palmar displaced fractures of the distal radius operated on between 1990 and 1995 were reviewed with a mean follow-up of 27.3 months (range, 8-54). Fifteen fractures were treated with palmar T-plates, two in combination with an external fixator. Five fractures were treated with external fixators and K-wires, and one fracture was treated with percutaneous K-wires and a cast. In six patients cancellous bone graft from the iliac crest was used. The most satisfactory clinical and radiological results were obtained by anatomical reconstruction of the articular surface. The favoured method remains stabilization with palmar T-plates. K-wires with a cast should only be used in simple articular fractures with a large palmar fragment.

Open Reduction and Internal Fixation of Intra Articular and Unstable Fractures of the Distal Radius Using the AO Distal Radius Plate

“…The results of treatment compare favourably with other studies on open reduction and internal fixation of less severe distal radial fractures and with other methods of treatment (Jakim et al, 1991). Twenty-one of the 25 fractures in this study were classified as severe complex articular (C3) by the AO Classification System, while previous studies on internal fixation of distal radial fractures feature less severe injuries and palmar displaced fractures where the good outcome following open reduction and internal fixation is already proven (Nienstedt, 1999). Postoperative radiographic measurements revealed restoration of palmar (positive) tilt in all but three patients and radial height and inclination were uniformly improved.…”