Outcomes of Open Reduction and Internal Fixation of Bilateral Fractures of the Distal Radius

Abstract

Background Bilateral distal radius fracture (DRF) is an uncommon injury. We described the outcomes of 10 consecutive cases of bilateral DRF treated with open reduction and internal fixation (ORIF) at our institution. Materials and Methods We retrospectively searched our electronic medical records data for all patients 18 years of age or older treated surgically for bilateral DRF over a 6-year period (2011–2016). Patient demographics, fracture classification, fixation method, postoperative complications, QuickDASH (Quick Disabilities of the Arm, Shoulder and Hand) questionnaire scores, wrist range of motion (ROM), and radiographic measurements of X-rays at final follow-up were collected and analyzed. Results Ten patients (8 women; 2 men; mean age: 63 years) with 20 fractures were assessed. A volar approach for ORIF was used in 90% of cases. Six of 20 (30%) wrists experienced postoperative complications and required hardware removal. Mean QuickDASH score was 24.8 at final follow-up. On average, ROM reached 58-degree extension, 52-degree flexion, 75-degree pronation, and 75-degree supination. Mean measurements of radial shortening, radial inclination, and volar tilt taken from final postoperative radiographs were 1.3 mm, 21.2 degrees, and 7.8 degrees, respectively. Conclusion In bilateral DRF treated with concomitant ORIF, functional outcomes, recovery of wrist ROM, and restoration of radiographic parameters are comparable to those seen in patients with ipsilateral DRF.

Good functional recovery after bilateral elbow dislocation associated with bilateral distal radius and ulna fractures

“…A recent retrospective study of 10 bilateral radius fractures treated with open reduction and internal fixation showed complications in one-half of the patients after a mean 2.4-year follow-up. 36 As there are no standardized and evidence-based protocols for the treatment of complex bilateral upper extremity injuries, a question remains whether something could have been done differently. Both distal radial fractures could have been treated with open reduction and internal fixation using plates and screws, but our idea was to use minimally invasive methods to yield the best result.…”

“…For the open or highly comminuted fractures, external fixation can be used. A recent retrospective study of 10 bilateral radius fractures treated with open reduction and internal fixation showed complications in one‐half of the patients after a mean 2.4‐year follow‐up 36 …”

The external fixation can be a good alternative to plate-screw treatment in the surgical treatment of bilateral distal radius fractures: A retrospective cohort study

“…Bilateral DRFs are exceedingly rare compared to unilateral DRFs. [12] While 87% of unilateral DRFs are treated conservatively, [3] ORIF is the most widely adopted surgical treatment. [13] No specific treatment has been described for bilateral DRFs in the literature.…”

“…Williksen et al [14] used both the Q-DASH and the MAYO scores; however, some surgeons used only Q-DASH scores. [4,[11][12][13] In a meta-analysis, Wang et al [15] reported that higher DASH scores were observed with ORIF, compared to EF. In contrast, one year later, in the meta-analysis of Lee et al, [16] there was no significant difference between the ORIF and EF groups in terms of the Q-DASH scores.…”

Bilateral distal radius fractures with seven month pregnancy during the peak period of national lockdown due to COVID 19 pandemic in Nepal: A case report

“…Distal radius fracture is one of the most common orthopedic injuries treated by orthopedic surgeons, however, simultaneous bilateral distal radius fracture in the adult population is a relatively rare injury. 1 , 2 , 3 To the best of our knowledge, bilateral distal radius fracture associated with pregnancy during the lockdown period of COVID 19 is not only the challenging injury pattern but also un-reported in the literature to date. However, there are very few studies reporting bilateral distal radius fractures during pregnancy.…”