This is a retrospective study evaluating the outcome of reduction plating of the depressed palmar lunate facet in conjunction with standard external fixation. The authors retrospectively reviewed 21 patients who underwent external fixation for high-energy C3 fractures of the distal radius. Following application of external fixation, 21 patients with C3 fractures still had residual depression of the palmar lunate facet. Ptients underwent a limited incision with placement of a small palmar plate on the lunate facet. The external fixator was kept in place. The results indicated that 18 of 21 patients were rated excellent or good using the Gartland-Werley's classification scale.
One interesting point that this paper highlights is that the arc of motion and the grip strength improved between six months and two years of follow-up. The paper notes that the total arc of flexion/extension at six months was 90º, whereas total flexion/extension motion at two years was 133º. In addition, grip strength improved as compared to the contralateral side from 56% to 93% over this time period, again indicating the prolonged nature of recovery following these injuries. This information is important for patients and physicians treating these fractures.
Journal of Orthopaedic Trauma