Open reduction and internal fixation of intra-articular smith fractures of the distal end of radius

ABSTRACT

The results of fifteen patients with displaced intra-articular Smith fractures of the distal end of radius treated by open reduction and internal fixation were evaluated. Buttress plate, Kirschner wire or both were used in all cases. At a mean follow up period of 31 month, 80% of the patients had a good or excellent rating by the scoring system of Gartl and and Werley, but only 60% had such a rating when the modified scoring system of Green and O'Brien was used. All of the fractures were healed at an average of ten weeks. A step-off two millimeters or more in the distal radial articular surface at the time of healing was important because the five patients in whom the fracture healed with this amount of incongruity had post- traumatic arthritis at the follow up period compared with only two patients with step-off less than two millimeters and did not affect the final result: