EXPERIENCE WITH THE AO ‘P1’ PLATE FIXATION IN COMMINUTED INTRAARTICULAR FRACTURES OF THE DISTAL RADIUS

The ‘Pi’ plate is an anatomical titanium plate recently introduced for the internal fixation of comminuted intra-articular distal radius fractures. We report our experience with this implant in a prospective series of twelve patients with an average age of thirty six years (range, 26–52 years). A dorsal approach with release of the EPL tendon and extra-compartmental exposure of the radius between the second and fourth extensor compartments was employed in all cases. Iliac bone graft and a styloid K-wire were used to augment the plate fixation. Post-operatively, active mobilisation was started after wound healing. Wrist motion and grip strength measurements were made at six weeks, three months and six months by the therapist. At six months, patients recovered an average of 85% of range of movement compared with the opposite wrist, except for palmar flexion (65%). No loss of reduction was observed on follow-up radiographs. Complications were compartment syndrome, intraoperative EPL rupture and two cases of extensor tendonitis requiring implant removal. The ‘Pi’ plate affords rigid fixation of distal radius fractures permitting early rehabilitation. It is however a demanding technique that is not without complications.