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Background Treatment of intra-articular distal radius fractures (DRFs) rests on anatomic internal fixation. Fragment-specific fixation (FSF) is applied when fracture pattern is too complex for standard volar plating (SVP), oftentimes with potential increased risk of complications. We hypothesized that patients undergoing FSF would achieve less wrist range of motion (ROM) with higher risk of complications compared with SVP. Methods We conducted a retrospective review of 159 consecutive patients undergoing DRF fixation from 2017 to 2020. Patients Results Ninety-two patients met all inclusion criteria: 59 underwent SVP and 33 underwent FSF. Average wrist ROM for patients undergoing SVP was 57 degrees/50 degrees flexion-extension and 87 degrees/88 degrees supination-pronation; average ROM for patients undergoing FSF was 55 degrees/49 degrees flexion-extension and 88 degrees/89 degrees supination-pronation. No significant differences were identified when comparing final wrist flexion (p = 0.08), extension (p = 0.33), supination (p = 0.35), or pronation (p = 0.21). Overall reoperation rate was 5% and higher for FSF (12%) versus SVP (2%). Highest reoperation rate was observed in the double volar hook cohort (80%; N = 4). Conclusion Construct type does not appear to affect final ROM if stable internal fixation is achieved. SVP and FSF had similar complication rates; however, double volar hook constructs resulted in increased reoperations likely from fixation failure and plate prominence. Level of Evidence Level IV, retrospective review.

Around one third of patients who undergo total knee arthroplasty (TKA) will eventually have the contralateral knee replaced. Overall patient satisfaction after staged bilateral total knee arthroplasty procedures performed on different days is reportedly similar to unilateral TKA. Nevertheless, in our anecdotal experience patients often report less satisfying outcomes following the second side. A cursory review of available literature tended to confirm that observation. We sought therefore to consolidate all of the available data on this issue to further investigate this phenomenon.To consolidate available published data revealing satisfaction scores among patients following staged bilateral TKA, and to evaluate the phenomenon of less satisfying results following TKA2.A systematic review of available literature reporting on satisfaction with TKA1 and TKA2 after staged bilateral knee arthroplasty was undertaken using PubMed, Google Scholar, and Embase. From 427 records, five full-length articles met criteria for inclusion in the meta-analysis. The data were then extracted and assessed on the basis of theA total of 1889 patients with an average age of 68 (range: 38-92) underwent staged bilateral TKA with outcomes reported at 1 year following each TKA with a mean 21.9 mo between surgeries (range: 2 d to 14.5 years). Overall satisfaction with both knees was 83.70% (1581) and dissatisfaction with both knees was 2.75% (52). In the remaining 13.56% (256) who were dissatisfied with one side, 61.0% were dissatisfied with TKA2, and 39.0% were dissatisfied with TKA1. Patient-reported outcome scores for TKA2 were frequently lower than TKA1 even in patients reporting overall satisfaction with both knees.At 1-year follow-up, there was a 50% greater risk of dissatisfaction with TKA2 among the 13.56% of patients reporting dissatisfaction in one knee after staged bilateral TKA. Whether the interval between procedures or long-term follow-up changes these results requires further investigation.