Open reduction and internal fixation for Die-punch fracture of distal radius / 中国矫形外科杂志

ABSTRACT

[Objective]To discuss the surgical technique and clinical effects of open reduction and internal fixation with T style plate in the treatment of Die-punch fracture of distal radius.[Method]From August 2003 to October 2007,twenty-nine patients diagnosed as Die-punch fracture according to X-ray and computerized tomography were treated with open reduction through volar approach and internal fixation with T style plate and bone-grafts to support the articular surface of impacted fractures.There were 20 males and 9 females,with an average of 40.5 years(range 19-62 years).The fractures were caused by falling(n=23),traffic(n=4) and by athletics(n=2).There were 6 cases of open fracture.Eighteen cases were in the right wrist,and 11 in the left wrist.The displacement of articulatzons was from 1.5 to 3.5 mm.[Result]Twenty-six patients were followedup for 9 to 45 months,with an average of 28 months.Posteroanterior and lateral radiographs were taken periodically and fracture healing occurred all within 12 weeks.According to ADL standard and radiographs,21 cases were excellent(ADL scores:38-40),3 cases were good(scores:35-37).The excellent to good rate was 92.3%.No infection occurred.[Conclusion]Open reduction and internal fixation can help restore the smoothness of the articular surface and reduce the incidence of traumatic osteoarthritis.It is effective against the Die-punch fractures of distal radius.