Little Fragments, Big Problems: The Role of Little BITs in Distal Radius Fracture

Abstract

Introduction Intra-articular fracture of the distal radius may have fragments deemed especially complex because of the difficulty in their synthesis or their relevance in joint stability. Little BITs are these small fragments that we must BE AWARE of, IDENTIFY properly, and TREAT CAREFULLY. The Little BITs consist of the small dorsal ulnar fragment (DUF), the radial or central depression (CD), and the small or comminuted volar rim fragment (VRF). This study aims to describe the Little BITs and evaluate their frequency in intra-articular fractures of the distal radius. In addition, we propose surgical possibilities for their treatment.

Method This is a retrospective study of clinical and imaging records of a series of 201 patients with distal radius fractures undergoing surgical treatment. We evaluated demographic variables, AO classification, and the presence of Little BITs in computed tomography (CT) scans.

Results The study included 173 patients, 60% male, and a mean age of 48.5 years. Most (96.5%) presented type C fractures according to the AO classification. At least one Little BIT was present in 61.3% of the patients. DUF was the most frequent (35.3%), followed by VRF (24.3%) and CD (13.3%). Only two patients had the three Little BITs at the same time.

Conclusion Little BITs are frequent in intra-articular distal radius fractures, being detected in 61.3% of our series.

Keywords

distal radius fracture - wrist arthroscopy - hand surgery

Publication History

Received: 03 October 2022

Accepted: 07 March 2023

Article published online:
07 June 2023

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