Functional Outcomes Associated With Bridge Plate Fixation*

Functional Results
StudyLevel of EvidenceStudy DetailsFlexion (deg)Extension (deg)Pronation (deg)Supination (deg)Radial Deviation (deg)Ulnar Deviation (deg)Strength (% of contralateral side)Complications and Patient-Reported Outcomes
Plating to 2nd metacarpal
 Hanel et al.14IV (retrospective case report)1 patient, case report via chart review, average 12-mo functional results453570601030NANo complications. DASH: NA
 Hanel et al.14IV (retrospective chart review)62 patients, chart reviewNANANANANANANANo CRPS, ECRL rupture (1), implant failure (1), postoperative digit stiffness (0). DASH: NA
 Dodds et al.24IV (retrospective review)25 patients (average age, 54.6 yr), average 6.6-mo follow-up and functional results464276691418NAEPL entrapment (0), extensor tendon rupture (0), infection (0), radial sensory nerve injury (0), hardware failure (3). DASH: NA
 Lauder et al.23IV (retrospective cohort with systematic follow-up)18 patients (average age, 61 yr), average 32.4-mo follow-up after plate removal43466671192386% grip, 78% extension (total cohort); 95% grip, 95% extension (dominant injury subgroup)Tendinitis (0), tendon rupture (0), infection (0), wrist pain (2). DASH (32.4 mo), 16. PRWE (32.4 mo), 14
Plating to 3rd metacarpal
 Burke and Singer9IV (case report)1 patient, case report, 4-yr functional results45658075NANANANo complications. DASH: NA
 Ruch et al.10IV (prospective cohort)22 patients (average age, 55 yr), average 24.8-mo follow-up, average 12-mo functional results57657776NANA69% grip (total cohort)Infection (3), extensor lag long finger (3). DASH (24.8 mo): 11.5
 Mithani et al.19IV (case series)8 patients (average age, 68 yr), ± use of additional volar plate fixation in addition to bridge plate, all procedures were performed to treat prior distal radial nonunion, final follow-up time not reported36407972NANANAPersistent pain (1). DASH (final): 27.6
Plating to either 2nd or 3rd metacarpal
 Hanel et al.15IV (retrospective chart review)134 patients, 2nd or 3rd metacarpal, numbers for each group not reported, follow-up not reportedNANANANANANANAWound-healing (3), implant failure (5), malunion (2), nonunion (2), deep infection (2), extensor tendon adhesions (2), EPL rupture (1). DASH: NA
 Richard et al.17IV (retrospective review)33 patients (average age, 70 yr), 2nd metacarpal (12 patients) or 3rd metacarpal (21 patients), average 11.8-mo follow-up and functional results46507977NANANADigital stiffness (10), index finger adhesion and tenolysis (1), superficial radial neuritis (1), CRPS (1), infection with poor wound-healing and skin graft (1). DASH (11.8 mo): 32
  • * Adapted from: Lauder A, Agnew S, Bakri K, Allan CH, Hanel DP, Huang JI. Functional outcomes following bridge plate fixation for distal radius fractures. J Hand Surg Am. 2015 Aug;40(8):1554-62, ©2015, with permission from Elsevier.

  • NA = not available; DASH = Disabilities of the Arm, Shoulder and Hand; CRPS = complex regional pain syndrome; ECRL = extensor carpi radialis longus; EPL = extensor pollicis longus; PRWE = Patient-Rated Wrist Evaluation.

  • The values are given as the average.