Incidence and reasons for hardware removal following operative fixation of distal radius fractures

Purpose To determine the incidence and reasons for hardware removal after operative fixation of distal radius fractures. Methods We retrospectively reviewed 33 patients who underwent removal of a volar distal radius plate from 2007 to 2013. We recorded the primary reason for plate removal, patient sex, body mass index, AO fracture type, and plate manufacturer. The total number of both distal radius plating procedures and implant removals was analyzed. Results Of the 33 patients who underwent implant removal, the most common reasons for removal were pain (30%), tenosynovitis (27%), malunion (24%), infection (12%), nonunion (6%), and tendon rupture (3%). The most common AO fracture types requiring plate removal were A2, C2, and C3 (7 each). A total of 517 distal radius fractures received plate fixation at our institution from 2007 to 2009, a number that rose to 610 from 2010 to 2012. The number of distal radius plate removals over that same time was relatively constant at 17 and 16, respectively. Conclusions We advise continued review of reasons for implant removal to limit future hardware complications related to volar plating of distal radius fractures. Type of study/level of evidence Therapeutic IV.