Clinical, functional and radiological outcomes of volar locked plating of distal radius fracture: A prospective study

Abstract

Background: The fracture of lower end radius is the most common fracture of the upper extremity encountered in practice and constitutes 10 to 20% of all the fractures and 75% of all forearm fractures. In spite of various new advances, closed reduction and cast immobilization has been the mainstay of treatment of these fractures, but malunion of fracture and subluxation /dislocation of distal radioulnar joint resulting in poor functional and cosmetic results is the usual outcome. Recently, the volar locked plate osteosynthesis is considered as the "gold standard" in treatment of 'unstable' distal radius fractures. The present study proposed to evaluate the role of volar locking plate fixation in the management of intra-articular and extra-articular volar fractures of distal end radius and to evaluate the clinical, functional and radiological outcomes. Aim and Objectives: To study the improvement in clinical, functional and radiological outcomes of volar locked plate fixation in a distal end radius fracture. Materials and Methods: A prospective study was undertaken in a Tertiary Hospital from September 2016 to September 2018, 30 patients (age >20 yrs) with volar fracture of lower end of radius i.e. AO types A 2.3, B 3.1, B 3.2, B 3.3 operated with volar locked plating. The patients were followed up at 2 nd , 6 th , 12 th and 24 th postoperative weeks. Radiological & clinical, functional outcomes were assessed by using Stewart score & PRWE (Patient-rated wrist evaluation questionnaire) score respectively. Data collected of these 30 patients were statistically analysed using ANOVA chisquare test. Results: Clinical and Functional outcome by Patient Rated Wrist Evaluation scoring system shows maximum no. of patients come in Good and Excellent grading i.e. 17(56.7%) and 8(26.7%) out of 30 patients, along with this 1(3.3%) Fair and 4(13.3%) Poor result. Radiological outcome by Stewart I scoring system is Maximum no. of cases shows Good and Excellent results i.e. 20(66.7%) and 6(20%) out of 30 patients. With this 1(3.3%) Fair and 3(10%) Poor result. Conclusion:Open reduction and internal fixation with volar locked plating has satisfactory functional and radiological outcome with minimal complications and thus it is an excellent modality to treat volar fractures of distal end radius.