DRIM-Nail Fixation of Extra-Articular Distal Radius Fractures: Functional and Radiological Outcomes

Abstract The distal radius intramedullary nail (DRIM-nail) was developed as a minimally invasive alternative to traditional fixation methods for extra-articular distal radius fractures. This study evaluates functional and radiological outcomes following DRIM-nail implantation. A retrospective case series was conducted, including all patients who underwent DRIM-nail fixation between January 2019 and August 2025. Primary outcome measures included radiographic parameters (fracture consolidation, volar tilt, radial inclination, and ulnar variance) and functional assessments (range of motion [ROM], grip strength, and pain levels). Complications and revision surgeries were also analyzed. Twenty-two patients (19 female and 3 male) with a median follow-up of 11.7 months (interquartile range [IQR]: 7.1, 12.5) were analyzed. Radiographic assessment showed fracture consolidation in all cases, with a median volar tilt of 12.3 degrees (IQR: 7.9, 15.3), radial inclination of 24.0 degrees (IQR: 21.3, 25.1), and ulnar variance of + 0.75 mm (IQR: − 0.80, + 1.50). Functional evaluation revealed no significant differences in grip strength or ROM compared with the contralateral side (all p > 0.05). No complications such as tendon irritation or nerve lesions have been observed. Two hardware removals were performed at the explicit request of the patients. The DRIM-nail provides stable fixation for extra-articular distal radius fractures while preserving soft-tissue integrity. Short-term outcomes demonstrate good safety, satisfactory functional outcomes at final follow-up, and minimal complications. These findings suggest that the DRIM-nail may represent a viable alternative to traditional volar plating in selected extra-articular fractures and warrants further investigation in larger cohorts. Level IV (therapeutic; case series).