Volar Fixed-Angle Plating of Distal Radius Fractures

Abstract

This biomechanical study showed a statistically significant difference between the locking screw and locking smooth peg configuration with regard to stiffness of the constructs after 1000 cycles. The use of locking screws as opposed to smooth locking pegs for OTA type A3 extra-articular distal radius fractures optimizes construct stability.

Volar Locking Plating of Extra-articular Distal Radius Fracture: A Retrospective Clinical Study Comparing Locking Screws versus Smooth Locking Pegs

“…8 In a cadaveric model, Mehling et al found a statistically significant difference between pegs and screws with regard to the stiffness of torsion after 1,000 cycles of axial and torsional loading in favor of screw fixation in both cases. 7 Yao et al in a cadaveric model found no difference in stiffness and failure load between the two constructs in axial load, but torsional loading was not evaluated. 9 Regarding intra-articular distal radius fracture, Boretto et al found no difference in a retrospective clinical study including adult patients with AO C2-C3 fractures treated with a volar plate with locking smooth pegs or locking screws.…”

“…Smooth locking pegs are easier and quicker to insert but could be more difficult to remove compare with locking screws. 6 Most of biomechanical studies that compare stability between locking screws and smooth locking pegs found that the use of locking screws optimize construct stability, 4,7,8 but a more recent study showed no significant differences in stiffness and failure load. 9 One clinical study has compared the stability fixation between locking screws or smooth locking pegs in intra-articular distal radius fractures and no significant difference was found.…”

Distal radius kırıklarının cerrahi tedavisi

“…Parçaların direkt manipülasyonu ile redüksiyon [17] Sabit açılı plak uygulamasında distal kısımda vida kullanımı biyomekanik olarak kadavra çalışmalarında peg kullanımına göre üstün bulunmuştur. [18] Distal sırada kullanılacak vida sayısı kullanılan implant ve kırık tipine göre değişim gösterse de, tek sıra vida kullanımı birçok kırıkta redüksiyonu korumak için yeterlidir. [19] Çoğu yazara göre, instabil kırıklarda volar kilitli plak yeterli stabilite, iyi fonksiyonel ve klinik sonuç sağlamaktadır.…”

Damage in a Distal Radius Fracture Model Treated With Locked Volar Plating After Simulated Postoperative Loading

“…Volar locked plating, popularized by Orbay et al 10,11 , allows for positioning of the plate on the volar cortex of the radius while supporting the distal bone fragments containing the lunate and scaphoid facets. This technology has been evaluated biomechanically focusing on differences due to: dorsally placed plating systems 12,13 , unlocked volar plate systems 13 , plate design 14–17 , fracture type 14 , use of screws vs. pegs 14, 15, 18 , and number of locked screws used for fixation 19–21 . These studies independently found that the locked volar plating systems provide sufficient stiffness and strength for use in treatment of extra-articular and intra-articular distal radius fractures with and without dorsal comminution.…”