• Lukas Daniel Iselin, Anne-Sophie Massy-Budmiger, Raoul A Droeser, Tobias R Mett, Reto Babst, and Daniel A Rikli.
• From the Department of Orthopaedic Surgery and Traumatology (LDI, A-SM-B, TRM, RB), Kantonsspital Lucerne, Lucerne; Department of Surgery (RAD); and Department of Surgery (DAR), Trauma Unit, University Hospital of Basel, Basel, Switzerland.
• Medicine (Baltimore). 2016 May 1; 95 (18): e3509e3509.

AbstractComplex distal intra-articular radial fractures (AO Type C3) are rare, but are life-changing injuries. They are usually related to high-velocity trauma mechanisms in a working male population.We surveyed a cohort of these fractures treated in our institution to assess the functional long-term outcome.Twelve consecutive patients with comminuted intra-articular distal radial fractures were treated at our institution. Osteosynthesis was performed by a single senior surgeon with volar and dorsal extended approaches. The intermediate and final control included conventional X-ray, range of motion (ROM), grip strength, and the Disabilities of the Arm, Shoulder, and Hand index (DASH), as well as the Patient-rated Wrist Evaluation (PRWE) score for functional outcome at 1 and 10 years' of follow-up.At 10 years' follow-up, anatomic reconstruction with a step or gap of <1 mm was achieved in 10 of the 12 above-mentioned patients, whereas 2 patients were lost to follow-up. ROM was good to excellent in 8 patients. Median grip strength was 107% of the contralateral side. Median DASH-Index and PRWE were 2.3 and 6 respectively, at 10 years. Eight patients returned to premorbid heavy labor. One patient was retired at the time of injury.Combined volar and dorsal approaches allow achieving anatomical reconstruction in comminuted intra-articular distal radius fractures and reveal good functional outcomes at intermediate and long-time follow-up.

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