Dorsal Bridge Plate for Distal Radius Fractures: A Systematic Review.
PURPOSE
This study presents patient demographics, injury characteristics, outcomes, and complications associated with dorsal bridge plating (DBP) in the treatment of distal radius fractures.


METHODS
A literature search performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines identified 206 articles, 12 of which met inclusion criteria, accounting for 310 patients. Included articles contained the results of DBP for treatment of distal radius fractures with reported outcomes between 1988 and 2018. Data were pooled and analyzed focusing on patient demographics, as well as 3 primary outcomes of complications, range of motion (ROM), and Disabilities of the Arm, Shoulder, and Hand (DASH) and QuickDASH scores.


RESULTS
Average age was 55 years, median follow-up was 24 months, and the most common use was in comminuted (92%) intra-articular (92%) distal radius fracture caused by fall (58%), or motor vehicle collision or motorcycle collision (27%). A minority of patients had open fractures (16%) and most were cases of polytrauma (65%). Median time from placement to DBP removal was 17 weeks (mean, 119 days). At final follow-up, mean wrist ROM was 45° flexion, 50° extension, 75° pronation, and 73° supination. Mean DASH score was 26.1, and mean QuickDASH score was 19.8. The overall rate for any complication was 13%; the most common was hardware failure (3%) followed by symptomatic malunion or nonunion (3%), and persistent pain after hardware removal (2%).


CONCLUSIONS
Dorsal bridge plating was found to be used most commonly in intra-articular, comminuted distal radius fractures with overall functional wrist ROM, moderate patient-reported disability, and a 13% complication rate at follow-up.


TYPE OF STUDY/LEVEL OF EVIDENCE
Therapeutic IV.
['Fares|Austin B|AB|', 'Childs|Benjamin R|BR|', 'Polmear|Michael M|MM|', 'Clark|DesRaj M|DM|', 'Nesti|Leon J|LJ|', 'Dunn|John C|JC|']
D001860:Bone Plates D005593:Fracture Fixation, Internal D018460:Fractures, Comminuted D006801:Humans D008875:Middle Aged D011885:Radius Fractures D016059:Range of Motion, Articular D012189:Retrospective Studies D016896:Treatment Outcome D014955:Wrist Joint
dorsal bridge plate Distal radius fracture distraction plate internal radiocarpal distraction plate spanning bridge plate