Functional Outcome Following Removal of Locked Volar Distal Radius Plates

Abstract

Objective: Volar plate fixation has become the preferred method of internal fixation for distal radius fractures. Most of the literature reports volar plate fixation for distal radius fracture can acquire satisfactory treatments. However, little information is available about the outcome after implant removal following the operative treatment of distal radius fracture. The functional outcome may significantly improve because of removal of the plate. The purpose of this study was to evaluate the functional outcome following the distal radius plate removal. Materials and Methods: From January 2012 to December 2014, 30 patients were treated with internal fixation and plate removal. Inclusion criteria of the patients requested to remove the plate included age of 18 to 80 years and a minimum follow-up of 6 months after plate removal. Exclusion criteria include tendon irritation, implant breakage, or a persistent infection, and if they could not be reached for follow-up. Nineteen patients were available at the last follow-up, including 11 men and 8 women with a mean age of 48.2 years (range, 19-70 years). We obtained data before and after surgery on wrist motion, forearm supination and pronation, grip and lateral pinch strength, as well as Disabilities of the Arm, Shoulder and Hand (DASH) scores, Visual Analog Scale (VAS) scores, and Gartland-Werley scoring system. Wrist motions included extension-flexion and radioulnar deviation. For continuous data, mean ± SD (parametric data) were calculated. Differences were assessed using the Student’s t test (parametric data) or the Mann-Whitney U test (nonparametric data). Categorical data were compared using the rank-sum test. Results: All hardware was successfully removed from the 19 patients. Mean time was 28 minutes. No patients presented with new complaints following implant removal. Functional outcome had significantly better VAS and Gartland-Werley scores, grip strength, and range of motion of flexion, extension, and pronation after the plate removal. No statistical difference in pinch strength, radioulnar deviation, and forearm supination was detected between preoperation and postoperation. Conclusions: Implant removal following operative distal radius fracture treatment can improve the functional outcome of the hand and forearm. The existence of the plate is one of the most important factors affecting the functional outcome of distal radius fracture. Thus, when we evaluate the surgical treatment outcome of distal radius fracture, the factor of the plate should be considered.