Functional outcome of distal end radius fractures treated with periarticular locking plates

Abstract

Introduction: Currently, the majority of intra-articular fractures of the distal radius are managed by the volar approach. It is useful to have a family of plates to address this complex fracture pattern from both a volar and dorsal approach. The purpose of this study is to asses the management of comminuted distal radius fractures with fragment specific plate fixation. Material and Methods: The study was a retrospective study conducted including two trauma centers, over a period of one year. The primary outcome was measured by Patient Rated Wrist Evaluation (PRWE) at 3rd, 6th &12thmonth. Secondary outcomes were assessed with radiographic measures (shortening (ulnar variance), dorsal angulation, radial tilt, articular step) measured at presentation, postreduction and between 6 weeks and 12 months). Results: From a study population of 50 patients the study group showed 16% of type A, 36% of type B and 48% of type C fractures. At the 6 month follow-up, there was a mean of 150 of radial inclination, 2.5-mm radial shortening in 10 of the patients with type C fractures, no articular incongruity and a mean volar tilt of 3°. The score at 3rd month ranged from 45 to 70 with the mean score of 57.2±8.52, the score at 6th month ranged from 20 to 32 with the mean score of 25.3±3.6 and the score at 12th month ranged from 0 to 12 with mean score of 6.18±3.11. Conclusion: The lack of deterioration of the radiological parameters and the consistent improvement of the PRWE scores underline the versatility and stability provided by the fragment specific plates. Thus through this study we have come to the conclusion that fragment specific plates show better functional outcome in distal end radius fractures.