Fractures of the Distal Radius: A Randomized Controlled Trial of 180 Patients Comparing Volar Locking Plates and Alternative Fixation Methods

Abstract

For intra-articular and extra-articular distal radius fractures do volar locking plates (VLP) provide patients with functionally, clinically and radiologically superior results compared to fixation methods before their introduction; Kirschner wires, non-locking plates and external fixators? In this prospective, randomized controlled trial 180 participants with a median age of 65 (range 18-96) were followed up for 1 year. Outcome measures included Disability of Arm Shoulder and Hand (DASH) score, range of motion (ROM) and grip strength, radiological measurements (radial length, angle, tilt, ulnar variance and articular step) and complications. There was no statistical difference of DASH scores between groups at any time point. ROM differed at one and six weeks post operatively, favoring the VLP fixation. However these results were not sustained at 12 and 52 weeks. The results have confirmed VLP’s ability to maintain fracture reduction over 12 weeks compared to alternative fixation methods.