2.4 mm anatomical locking compression plate for treatment of type C distal radius fractures in elderly patients

Abstract

Objective To evaluate clinical outcomes of the elderly patients with type C distal radius fractures caused by osteoporosis who were treated by open reduction and internal fixation with 2.4 mm anatomical locking compression plate (LCP). Methods From October 2006 to November 2008, 21 elderly patients with comminuted unstable distal radius fractures caused by osteoporosis were treated by open reduction and internal fixation with 2. 4 mm LCP. They were 7 males and 14 females, with an average age of 76 years (range, 71 to 85 years). According to AO classification, there were 6 cases of type CI, 13 cases of type C2 and 2 cases of type C3. All of them were closed fractures of distal radius. All the fractures were fixed with 2.4 mm LCP by volar approach and dorsal soft tissues were not dissected during the operation. Artificial bones were implanted when the defects were large enough. Results The patients were followed up for 8 to 27 months (average, 10. 6 months) . The X-ray pictures showed primary union in all patients in a mean healing time of 8 weeks. Artificial bones were implanted in 2 cases. No infection, non-union, loosening of nails or carpal tunnel syndrome was found. Functional recovery was achieved in 4 to 36 weeks (average, 11 weeks) . Passive wrist motion, active finger motion and forearm rotation were encouraged immediately after surgery. Active wrist motion was suggested by 7 days postoperatively. The clinical outcomes were evaluated according to the modified Mcbide grading system. There were 14 excellent, 5 good and 2 fair cases, with a good-to-excellent rate of 90. 5%. Conclusion In treatment of unstable distal radius fractures caused by osteoporosis in elderly patients, the 2.4 mm LCP can result in a rigid fixation, early exercise, and an excellent clinical outcome. Key words: Radius fractures; Fracture fixation, internal; Plate