Evaluation of the Results of Volar Plating in the Treatment of Fractures of Distal End Radius

Abstract

Background- Fractures of lower end radius are most common fractures of the upper extremity, encountered in practice.Increased awareness of the complexity of the distal end radius fractures have stimulated a growing interest and promoted new ideas regarding their management. Closed reduction and cast immobilisation had been the mainstay of treatment of the DER fractures but complications resulting in poor functional and cosmetic results is usually the outcome. The volar plate system has been shown to be reliable for the fixation of distal radius fractures. As open reduction and volar plating ensure more consistent correction of displacement and maintenance of reduction, this prospective study evaluates the anatomical and functional outcome of open reduction and plate fixation in the management of fracture distal end radius. Objectives: This study was done to evaluate the role of the volar plate in the treatment of fractures of distal end of radius and to evaluate the functional results of this treatment in terms of deformity, disability, movements and grip strength. Assessment of complications that occurred with the surgical procedure was also done. Material and Methods: The study was done in Department Of Orthopedics and Traumatology at USSC, Indore from may 2013 to may 2015. 40 patients with distal end radius fractures were included in the study. Informed consent was taken. Clearance from the ethical committee of the institute was taken. The study was Prospective, interventional and observational for the methods used for management of the fracture. Patients were evaluated pre operatively and post operatively at the end of first,fourth,sixth week,3 months and then once in 3months upto 12 months. Results: In the prospective study conducted with forty patients,88% anatomical and 93% functional, excellent to good results suggests that stabilizing the fracture fragments with volar plateand screws in the management of the fractures of distal radius, is an effective method to maintain the reduction till union and prevent collapse of the fracture fragments, even when the fracture is grossly comminuted/intra-articular/unstable and/or the bone is osteoporosed. Conclusion: The study emphasizes that open reduction and internal fixation with volar platinghas excellent functional outcomewith minimal complications thus proving that volar plating is the prime modality oftreatment for distal end radius fractures. The procedure is applicable for all types of Frykman fractures in young patients with a good bone stock as well as in elderly osteoporotic patients. Keywords: VolarPlating, Distal Radius Fractures,distal end radius.