Surgical Fixation of Fractures of the Distal Radius within 2 Weeks Reduces Postoperative Finger Stiffness

Locked volar plating remains the most common form of surgical fixation for displaced fractures of the distal radius. We hypothesised that delayed surgical fixation later than 2 weeks after injury contributes to poorer patient outcomes for patients with displaced or intraarticular fractures of the distal radius.

We conducted a retrospective cohort study of 158 patients who underwent locked volar plating for an intraarticular or displaced fracture of the distal radius using multiple regression analysis to identify any relationship between patient, injury or treatment factors with the Patient Rated Hand and Wrist Evaluation (PRHWE) or finger and wrist stiffness.

There was no significant correlation between timing of surgery and PRWHE scores. A delay in time to surgery of beyond two weeks did correlate with increased finger and thumb stiffness (p=0.01). However, this relationship was not seen for wrist stiffness.

Our study supports the consensus that early recovery and function is facilitated by surgical fixation within two weeks and that delayed fixation beyond this may contribute to protracted finger stiffness.