The operative treatment of intraarticular Smith fractures

Twenty-one intraarticular palmar displaced fractures of the distal radius operated on between 1990 and 1995 were reviewed with a mean follow-up of 27.3 months (range, 8-54). Fifteen fractures were treated with palmar T-plates, two in combination with an external fixator. Five fractures were treated with external fixators and K-wires, and one fracture was treated with percutaneous K-wires and a cast. In six patients cancellous bone graft from the iliac crest was used. The most satisfactory clinical and radiological results were obtained by anatomical reconstruction of the articular surface. The favoured method remains stabilization with palmar T-plates. K-wires with a cast should only be used in simple articular fractures with a large palmar fragment.