Abstract
BackgroundMultiple approaches for fixation of distal radius fractures exist; nonetheless, there is no consensus on the optimal treatment for these injuries. Although using volar locking plates has become increasingly common as a surgical intervention, the usefulness of bone augmentation remains debatable. Therefore, this study aimed to evaluate the necessity of bone augmentation for distal radius fractures fixed with a volar locking plate.MethodsThis retrospective study enrolled patients with a single distal radius fracture treated with a volar locking plate between January 2014 and December 2016. Overall, 105 fractures were included and divided into two groups (non-bone augmentation: group 1, n = 88; bone augmentation: group 2, n = 17). Images were reviewed, and dorsal cortex collapse, volar tilting, and radial height and inclination were measured immediately after surgery and at the 6-month follow-up.ResultsBoth groups exhibited significant differences in dorsal collapse (p < 0.001 and p = 0.001, respectively) and radial height shortening (p < 0.001 and p = 0.039, respectively); volar tilting and radial inclination did not differ significantly. There was no difference in the degree of dorsal collapse (p = 0.715) and radial height shortening (p = 0.651) between the two groups. Of the 105 fractures, 54 were identified as comminuted type according to the AO classification (A3, C2, and C3), and similar radiographic outcomes were noted.ConclusionsVolar locking plates for the treatment of distal radius fractures with or without bone augmentation do not affect the radiographic outcomes. In comminuted fractures, additional bone augmentation is unnecessary if intraoperative anatomical reduction and fixation are performed when possible.
Highlights
Multiple approaches for fixation of distal radius fractures exist; there is no consensus on the optimal treatment for these injuries
Additional bone augmentation is unnecessary if intraoperative anatomical reduction and fixation are performed when possible
Patients were excluded from the study if: (1) they underwent re-fracture or revision surgery, (2) they had an associated ipsilateral ulnar shaft fracture, (3) their surgery was performed without using the plate mentioned above, (4) no locking screw was present on the main combi-hole of the plate, (5) they were followed up for less than 6 months postoperatively, and (6) their treatment included the use of an additional external fixation instrument
Summary
Multiple approaches for fixation of distal radius fractures exist; there is no consensus on the optimal treatment for these injuries. Using volar locking plates has become increasingly common as a surgical intervention, the usefulness of bone augmentation remains debatable. This study aimed to evaluate the necessity of bone augmentation for distal radius fractures fixed with a volar locking plate. Chang et al BMC Musculoskeletal Disorders (2020) 21:180 intraoperative anatomical reduction, while using a lowprofile locking plate can reduce compression and irritation of the median nerve and flexor tendons. Due to these advantages, the volar locking plate is increasingly used for surgical fixation and has proven effective [6,7,8,9]
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