Functional and Radiological Outcomes of Dorsal Distraction Plating in Comminuted Distal Radius Fractures: A Prospective Study from a Tertiary Care Centre

Background: Distal radius fractures constitute a substantial proportion of upper limb injuries, accounting for approximately 10–15% of all adult fractures. Management of comminuted intra-articular fractures remains challenging due to instability, metaphyseal comminution, and difficulty in achieving anatomical reduction. Material and Methods: This prospective observational study was conducted between January 2023 and January 2026 at a tertiary care centre in Jaipur, India. A total of 25 adult patients with AO type 23-C2 and 23-C3 distal radius fractures were included. All patients were managed using dorsal distraction plating. Functional outcomes were assessed using wrist range of motion and the Mayo Wrist Score over a follow-up period of 36 weeks. Radiological parameters, including ulnar variance, radial inclination, and volar tilt, were evaluated. Statistical analysis was performed using SPSS version 25.0, with p < 0.05 considered statistically significant. Results: A statistically significant improvement in wrist mobility was observed over the follow-up period (p < 0.001). Mean wrist flexion improved from 36° at 4 weeks to 65° at final follow-up. Supination improved from 38° to 68°, while pronation increased from 27° to 58°. Based on the Mayo Wrist Score, 72% of patients achieved good to excellent functional outcomes. Radiological parameters were maintained within acceptable limits in the majority of cases. No major complications such as infection, implant failure, or neurovascular injury were encountered. Conclusion: Dorsal distraction plating is a reliable and effective technique for the management of comminuted distal radius fractures, providing stable fixation, satisfactory functional recovery, and acceptable radiological alignment with a low complication rate.

Keywords: Dorsal angulation, Distal radius, Plating, Dorsal Distraction.