Dorsal nail plate fixation of distal radius fractures.

Intramedullary fixation of distal radius fractures is an emerging concept. The Dorsal Nail Plate is a new device that links a specifically designed stem to a small distal plate; bone fixation is supported by fixed-angle screws. The device is inserted dorsally using a minimally invasive technique ; its indications are unstable dorsally displaced extra-articular or simple articular distal radius fractures. To evaluate the results obtained with this implant, we retrospectively studied 47 extra-articular (36 cases) or simple articular (11 cases) dorsally displaced distal radius fractures in 46 patients treated with this technique. Patients had a mean follow-up of 11 months and were evaluated radiographically and clinically using the Mayo Wrist Score and the DASH score systems. The minimally invasive operative technique is described. Complications occurred in three cases. Two were observed intra-operatively--partial rupture of extensor pollicis longus tendon--and one postoperatively--loosening of one epiphyseal screw. Excellent reduction was obtained at operation in all but two patients; loss of initial reduction was observed in 2 fractures. All fractures were considered healed radiologically at 40 days. Average final DASH score was 6 (0-20). According to the Mayo Wrist score, 29 patients had excellent, 12 good and 5 satisfactory results. The Dorsal Nail Plate (DNP) has shown to effectively stabilize distal radius fractures with dorsal displacement, leading to an early satisfactory functional recovery. Accurate surgical technique minimizes soft tissue dissection and reduces the risk of complications.