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Purpose: To investigate the incidence and characteristics of carpal fractures occurring concurrently with distal radius fractures and to determine the risk factors for this combination. Methods: We retrospectively analyzed 161 consecutive patients with 170 distal radius fractures who were treated between 2007 and 2011. Posteroanterior, lateral, and oblique radiographs of the wrist were examined, as were computed tomography scans when available. We evaluated the incidence and characteristics of carpal fractures occurring concurrently with distal radius fractures and the patient factors of gender, age, AO/ASIF classification, and energy of the injury. Results: Of the 170 distal radius fractures, 11 (7%) also had 1 or 2 carpal fractures. Of the 15 carpal fractures, 8 were scaphoid, 2 triquetrum, 2 pisiform, 1 capitate, 1 trapezium, and 1 hamate. Eleven of the 15 carpal fractures were diagnosed by computed tomography alone. Male gender, patients of lower mean age, AO/ASIF type B, and high-energy trauma significantly raised the risk of simultaneous fractures of the distal radius and carpals. Conclusions: The incidence of carpal fractures occurring concurrently with distal radius fractures was not negligible, and almost all carpal fractures had no or minimal displacement. Suspicion of carpal fractures occurring concurrently with distal radius fracture should be high, and computed tomography should be considered, in males, young patients, and those with AO/ASIF type B fractures and high energy trauma. Type of study/level of evidence: Diagnostic III. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the influence of distal plate placement for distal radius fractures on risk of flexor tendon complications and wrist motion by performing hardware removal. Materials and methods: Fourteen patients treated with a Synthes 2.4 mm juxta-articular LCP Distal Radius Plate underwent hardware removal at ≥6 months postoperatively when improvement of range of motion and grip strength were obtained. Location of plate placement, condition of the flexor tendons, range of motion, grip strength, and postoperative complications were evaluated. Results: The average minimum distance between the plate and joint line was 2.0 mm (range, 0.4-4.5 mm), and average distance at the base of the styloid process was 7.5 mm (range, 4.2-9.6 mm). All plates were located distal to the watershed line. Pathological conditions of flexor tendons were observed in 3 patients-adhesion of flexor pollicis longus in 1 and flexor tendon synovitis in 2-however, there were no cases of abrasion or rupture. The average active wrist flexion improved from 53.6° to 61.1°, extension from 67.5° to 70.7°, and the flexion-extension arc of motion improved from 121.1° to 131.8°. The flexion and flexion-extension arc were significantly improved ( P = 0.0003 and P = 0.007, respectively). The average grip strength increased from 18.5 to 19.4 kg (not significant). Temporary median nerve disturbance was observed in 1 patient as a postoperative complication. Conclusions: Removal of juxta-articular LCP Distal Radius Plate improved wrist motion. Plates located distal to the watershed line may increase the risk of flexor tendon complications and limit wrist motion. [ABSTRACT FROM AUTHOR]