The operative therapy of distal unstable radius fractures with dorsal and volar plates. A retrospective study with respect to the DASH-score system

The distal radius fracture is the most common human skeletal injury. Predominantly woman in the 6th to 7th decade are found. There is a high correlation to the post menopause high turn over osteoporosis and its negative calcium balance. Due to the various multifactoral radius fracture combinations is a detailed classification with its correlated treatment important. The operative intervention in the past played a secondary roll. The newest concepts demand an exact reconstruction of the articulating surfaces through closed reposition and K-wire support, screw osteosynthesis, external fixation and its combinated forms. The posttraumatical joint changes with secondary palmar and dorsal dislocation of the radius base after reduction caused the exact therapy scheme with respect to the AO-classification to be developed. In the clinic and policlinic Oskar-Helene-Heim of the Free University in Berlin 213 patients were surgicly treated on distal radius fractures either from volar or dorsaly with a plate osteosynthesis between 1988-1998. In cases of multidirectionional fractures with compression of the articular surfaces we combined a bicortal bone block or spongiosa to support and to avoid the secondary dislocation and thus arthrosis. The study was devided in three sections, beginning with the clinical inspection. Further followed the X-ray evaluation and the assessment of the DASH-scores.