Open reduction and internal fixation for distal radius fractures.

From a series of 650 dorsally angulated fractures of the distal radius, 32 intra-articular fractures were treated by open reduction and internal fixation. The 32 fractures were classified according to the Frykman criteria as type VII (5) or type VIII (27). On the basis of the location of intra-articular involvement, the fractures were further subdivided into Mayo type II (4), type III (18), and type IV (10). Results were analyzed by the methods of Gartland and Werley (functional) and Lidström (radiographic). After open reduction and internal fixation, 90% of the patients had satisfactory results on the basis of the subjective criteria of minimal deformity, absence of pain, and good strength. Objective assessment demonstrated that the patients had 80% of normal motion and 73% of normal grip strength at a minimum of 2 years after the operation. On the basis of radiographic and functional evaluation, results were good to excellent in 87%. When intra-articular step-off exceeded 2 mm or the radius was shortened more than 5 mm, the results were only fair and posttraumatic arthritis was evident.