Initial experience with the Forte plate for dorsally displaced distal radius fractures

Open reduction and plate osteosynthesis is occasionally indicated for dorsally displaced distal radius fractures. We reviewed our medium term results with the Forte plate, one of the recently introduced purpose-made implants. Twenty-five patients operated on during the first year were reviewed 19 (12-24) months after surgery. Median age at operation was 53 (28-80) years. There were seven high energy and eighteen low energy injuries. Fourteen fractures extended into the radiocarpal joint. Three patients had a poor clinical result and were re-operated on before review with an arthrodesis, ulnar shortening, or Sauve-Kapandji operation. The remainder had six excellent, twelve good, and four fair results. Irritation of the extensor tendons was a minor problem. Initial radiological correction of deformity was satisfactory, but increased volar angulation of the distal radius was seen at follow up in twenty patients - by more than 10 degrees in nine. Seven patients had 20-30 degrees volar tilt at final review and tended to have a poorer clinical result than other patients. In our patients use of the Forte plate seems to have given satisfactory clinical results, but the increase in volar tilt after surgery is a cause for concern. (C) 2000 Elsevier Science Ltd. All rights reserved.