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Table 4 Detailed list of categorised definitions for bone/fracture and implant/surgery complications located at the distal radius

From: Does osteoporosis increase complication risk in surgical fracture treatment? A protocol combining new endpoints for two prospective multicentre open cohort studies

(Secondary) Loss of reduction
= secondary fragment dislocation
= redisplacement
= loss of radial/ulnar length
= dorsal angle change
= dorsal or palmar shortening
Any change in intra-/extraarticular angles, radial/ulnar length or secondary fragment dislocation compared to the immediate postoperative measurements
Malunion Healed fracture in deformity (e.g. varus/valgus, rotational malunion) as a consequence of loss of reduction
= residual extraarticular deformity
= residual articular gap/step-off
Inadequate/insufficient anatomical reduction as a consequence of significant change of the postoperative position. Bone unites in abnormal position and/or alignment
Fracture impaction Articular impaction of ≥ 1 mm
Delayed healing Insufficient signs of healing (> 3 months)
Nonunion Indiscernible signs of healing (> 6 months)
= secondary fracture
Fracture occurs at the same radial site with a load level otherwise tolerated by normal bone after the bone has solidly bridged
Functional deficit As assessed with the functional scores of DASH, PRWE, ROM and grip strength
Primary malpositioning of plate Failure to fix each fragment and/or failure to implant plate according to technical guide [17] (including anatomical reduction and plate positioning) during operation
Primary malpositioning of screw Screws placed into the radiocarpal or radioulnar joint as seen on oblique X-rays or incorrect screw size chosen during operation
Secondary screw perforation
= secondary screw loosening
= screw back-out
Screws displaced into the radiocarpal or radioulnar joint as seen on oblique X-rays or incorrect screw size chosen (no initial perforation)
Implant (plate and screw) loosening Multiple proximal or distal screw loosening leading to firstly, relative movement between one main fragment and the plate and secondly, pull-out of the implant
Plate/screw failure/breakage Plate/screw breakage
Radiolucency around screw Appearance of screw on X-ray without screw loosening
  1. DASH = Disabilities of the Arm, Shoulder and Hand questionnaire PRWE = Patient-Rated Wrist Evaluation questionnaire ROM = Range Of Motion