Conventus DRS Intramedullary Fixation for Distal Radius Fractures: One Year Experience

Hypothesis: Conventus (Conventus Orthopaedics, Maple Grove, MN, USA) DRS is a novel FDA-approved intramedullary fracture fixation device used for distal radius fractures. We examine a series of 15 patients and report the outcomes and complications.

Methods: 15 patients with distal radius fractures (13 of these fractures were articular AO type C1 and C2; the remaining 2 were extra-articular AO Type A2 and A3) underwent open reduction with internal fixation (ORIF) using Conventus DRS by a single surgeon. There were 12 female and three male patients, with an average age of 51.3 years (range 30–74). Data including fracture type, radiographic parameters (variance, inclination, and tilt), grip strength, wrist range of motion (ROM), Patient Rated Wrist Evaluation (PRWE), and visual analog scale (VAS) pain scores were recorded at time of surgery and at standard follow-up.

Results: A single surgeon performed all 15 procedures without the use of a tourniquet. At first follow-up visit (avg. 9 days) all patients had full digital ROM (measured as a 0 cm tip-to-palm distance). No patients required a refill of their immediate postoperative pain medication prescription. At latest follow-up the VAS pain scores averaged 0.93 (range 0–7) and the PRWE averaged 19.2 (range 0–61.5). The grip strength of the operated hand was 47.1 kg (range 5–60) and 75% of the uninjured hand. Flexion-extension ROM measured 86%, radioulnar deviation measured 81%, and pronosupination measured 96% of the uninjured wrist. Two patients underwent prophylactic screw removal under local anesthesia at 8 weeks postoperative to prevent tendon irritation. Two patients had transient radial neuritis that resolved. One patient is scheduled for device removal. We otherwise had no major complications, including complex regional pain syndrome (CRPS), in the series to date.

Summary Points: The Conventus DRS fracture fixation system is a promising alternative to established methods of distal radius ORIF. Of 270 cases performed in Europe to date, there are no tendon ruptures reported. The complication rate as published in their white paper was 8.3% (5 out of 60 patients): one hardware-related complication and four transient radial neuritis cases that resolved. The complication rate of volar plating ranges from 3% to 34% in the literature. Our reported series has a low reported pain score for all patients, starting immediately postoperatively, and a low complication rate. This novel device is a promising option for internal fixation of displaced articular fractures of the distal radius with a low complication profile.