Complications and functional outcome following fixation of complex, intra-articular fractures of the distal radius with the AO Pi-Plate

This study investigates the efficacy of the AO Pi-plate in the treatment of complex, intra-articular fractures of the distal radius. We retrospectively analysed the clinical and radiological results of 19 consecutive patients who underwent open reduction and internal fixation for dorsally displaced, intra-articular fractures of the distal radius using the AO Pi-plate. The final functional outcome was assessed using the Gartland & Werley scoring system. The average follow-up period was 34.3 months. Wrist movement was restored to a near normal range in all the patients. The functional outcome as measured by the Gartland & Werley scoring system showed excellent and good results in 15 (88%) of the patients. The implant was removed in 4 (23%) of the patients due to extensor tenosynovitis and restriction of flexion. This study demonstrates that although the functional outcome following fixation of complex distal radius fractures with the AO Pi-plate is good, there is a risk of developing extensor tenosynovitis and limitation of flexion. We recommend that the implant be used sparingly and if used then elective removal of the implant should be considered after fracture union.