There has been a trend away from dorsal fixation of
distal radius fractures secondary to a historically higher complication rate. However, the literature on low-profile dorsal plates and
titanium implants for the treatment of these fractures is limited. The goal of the current study was to evaluate hardware-related complications and removal rates after open reduction and internal fixation of unstable, displaced
distal radius fractures using a dorsal approach with a low-profile
titanium plate. A single surgeon treated 125 patients with isolated, unstable, dorsally displaced
distal radius fractures by open reduction and internal fixation using a low-profile
titanium dorsal plating system. A total of 110 patients were followed for a minimum of 1 year, and mean follow-up was 27 months (range, 12-74). Outcomes were assessed radiographically and clinically. Satisfactory alignment was achieved in all cases, and no fracture went on to nonunion. Nine patients (8%) required removal of hardware at an average of 12 months (range, 6-34). Six patients (5%) had evidence of extensor
tenosynovitis intraoperatively, but no extensor tendon
ruptures were identified. Overall, using the Gartland and Werley score, results were excellent in 82 patients, good in 22 patients, fair in 5 patients, and poor in 1 patient. Six complications accounted for the fair and poor results. The average Disabilities of the Arm, Shoulder and Hand (DASH) score at latest follow-up was 6 (range, 0-25). This series showed that the technique of dorsal plating with a low-profile
titanium plate is safe and effective.