Complications after Pi Plate osteosynthesis

Background: Distal intraarticular radius fractures can be operated on by means of a palmar or dorsal approach. The dorsal approach has been reported as a treatment option that often leads to tendon ruptures. The purpose of this study was to show that a dorsal implant does not lead to a high rate of tendon ruptures. Methods: A retrospective study was conducted in which the patient population was analyzed for complaints and complications, follow-up time, and further surgical procedures. Results: A series of 389 patients with distal intraarticular fractures of the radius treated with the dorsal Pi Plate is reported. There was a complication rate of 6.7 percent within the first 2 postoperative months. A special focus was on the occurrence of extensor tendon ruptures, which occurred in five cases in the patient population. This most feared complication occurred within the first 8 months after surgery and in no case at a later stage. All tendon ruptures were reconstructed and healed without further complications. Hardware was removed in 75.5 percent of patients after 6 to 8 months. In the remaining 24.5 percent of patients, the plates were left in situ for more than 33 months, and 89 percent of these patients were free of pain and had excellent movement in the wrist. Conclusions: The authors conclude that the Pi Plate is a very good surgical option, especially in complicated, comminuted fractures classified as C3. It is not associated with an overly high risk of extensor tendon ruptures, as has been suggested by other authors.