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Functional Outcome of Open Reduction and Internal Fixation of Intra-articular Distal Radial Fractures by Buttress Plate

Introduction: Treatment of displaced, comminuted, intra-articular fracture of the distal end of the radius by a closed method, such as pins and plaster or external fixation, gives unsatisfactory outcome in most of the cases. The purpose of this study is to evaluate the efficacy of open reduction and internal fixation (ORIF) of intra-articular distal radial fractures by buttress plate. Materials and Methods: We conducted a prospective study from January 1, 2015, to June 30, 2016, on patients having intra-articular distal radius fractures aged above 18 years (20–58 years), who were treated by ORIF with buttress plate. Males outnumbered females by a ratio of 2.67:1. The most common mode of injury was found to be road traffic accident (68.2%). The fractures were classified as per the Frykman classification system. Type III was the most common (54.5%), followed by Type IV (27.3%). Majority of the cases (54.5%) were operated in 2–5 days following injury. The mean time for union was 8.04 weeks. Results: Functional evaluation was done according to the modified demerit point system of Gartland and Werley. Functionally, 14 patients (63.6%) had excellent, 6 had good (27.3%), and 2 had fair (9.1%) restoration of functions. Radiological assessment and the results were graded according to the Sarmiento's modification of Lindstrom criteria. Anatomically, 16 patients (72.7%) had excellent restoration, 4 (18.2%) had good restoration, and 2 had fair (9.1%) restoration. One case of superficial infection and one case of injury to the superficial branch of the radial nerve were noted. In later follow-up, two cases presented with joint stiffness, and in one case, loss of reduction was seen at final follow-up. Conclusion: Around 91% of the patients had excellent-to-good result, both anatomically and functionally. Hence, we conclude that ORIF with buttress plate is an excellent mode of treatment for displaced intra-articular distal radius fractures.