Osteosynthesis of Unstable Fractures of Distal Radius with Volar Locking Plate

Abstract

BACkGROUND: Various surgical treatment methods are available for unstable distal radius fractures. Clinical and radiological outcome with volar locking plate has been very satisfactory. The purpose of this prospective study is to evaluate the results of the treatment of unstable fractures with the volar locking plate with regard to loss of reduction, functional outcome and complications. METHODS:Unstable distal radius fractures were enrolled for the study from May 2008 until July 2010. All patients were treated with 3.5 mm distal radius volar locking plate and assessed by clinical and radiological examination. The clinical scoring chart modified by Cooney was used to evaluate the functional outcome.RESULTS: eighteen male and 12 female patients with the average age of 42.53 (range 30-64years) were followed up for a period of 9 to 34 months (average.23 months). There were fourteen A3 fractures, nine C1 fractures, six C2 fractures, and one C3 fracture, whereas one had a Gustilo grade I open wound on the volar aspect. Seven of the fractures had associate fracture of the ulnar styloid. The functional outcome was excellent in 23 (76%), good in 6 (20%), fair in 1 (4%) and none had poor outcome. There were very few complications in our series. CONCLUSION:Unstable fractures of distal radius treated by open reduction with volar locking plate provides adequate fixation with no collapse in reduction and also have satisfactory functional outcome with minimal complications.

Functional outcome of volar locking plate for unstable distal radius fractures

“…The most common mechanism of injury was fall from standing height (42.22%) as was the case with Arora et al (75.44%) 20 and Rozental et al (80.49%). 24 In our study the average time for union was 7.96 weeks which is similar to Pradhan et al 23 (8 weeks). Earlier union at 7 weeks was seen in studies of Arora et al, 20 Wright et al 26 and Orbay et al 9 According to modified Green and O'Brien Score we had 76% excellent to good results (43.48% excellent, 32.61% good).…”

“…Males were affected more in our study as well in other studies by Pradhan et al 23 and Drobetz et al 25 Female preponderance was seen in studies of Arora et al and Rozental et al 20,24 Males were affected more in the age group <40 years (M:F = 1.9:1), and this may be because males are more involved in outdoor activities and are thus more prone to trauma. There was female predominance in age group >= 40 years (M:F = 1:1.5), which may be because their bones are more osteoporotic post-menopause with increased the risk of fracture with trivial trauma like fall.…”

“…25 However Pradhan et al had upto 96.67% results (76.67 excellent, 20% good, n=30). 23 Assessment of radiological parameters showed a decrease in radial height of 0.32 ± 0.54 mm, radial inclination 0.500 ± 0.690 and radial tilt -0.150 ± 0.600 from postoperative period to final follow-up, the final follow-up values being 11.05 mm, 19.960 and 6.390 respectively. In the study of Arora et al, 20 there was a mean loss of palmar tilt of 3.40 ± 4.90 and radial inclination of 0.40 ± 1.…”

“…The average grip strength was 77% of the contralateral side in our study, and this was similar to other studies-75% Wright et al 26 and 77% Orbay et al 9 Other studies had a lower (70% of the contralateral side, Arora et al) 20 or a higher (94%, Rozental et al) 24 grip strength than our study. 23 had only 10% complications-2 superficial infection and 1 screw penetration into joint. No nonunion was seen in any of these studies as was the case in our study.…”

Functional Outcome of Intraarticular Fracture of Distal Radius Managed by Volar Locking Plate

“…In another study conducted by Ansari et al [ 16 ], the study's mean age was 39 years, which was almost comparable with our study. Males were most commonly affected in our study, comparable to the study conducted by other authors as well [ 17 ]. Though right-hand dominance was noticed in our study, the left side was most affected in about 27 (55.1%) cases compared to the right side, which was involved in 22 (44.9%) cases.…”