Locking compression plate combined with Kirschner wire fixation for treatment of high-energy type C distal radius fractures in young patients

Abstract

Objective To investigate the long-term efficacy of locking compression plate (LCP) combined with Kirschner wire fixation in treating high-energy type C distal radius fractures in young adults.Methods From June 2008 to November 2012,26 young adults (14 males and 12 females) with high-energy type C distal radius fractures were treated.The age of the patients averaged 28 years.According to AO classification,there were 14,6 and 6 cases of type C1,type C2 and C3 fractures,respectively.Twenty,4 and 2 cases were treated by fixation using LCP combined with Kirschner wire through volar,dorsal and radial approach,respectively.Postoperative evaluations included visual analogue score of wrist pain,active range of motion of the wrist,Gartland-Werley score,Batra radiological score and complications.Results In 26 patients,the follow-up duration was 18 to 48 months,the average being 26 months.Fracture healing time was 12 to 24 weeks,with an average of 18 weeks.The time of Kirschner wire removal was 3 to 5 weeks postoperatively (mean,4 weeks),and that of plate removal was 12 to 18 months (average 14 months).Reflex sympathetic dystrophy occurred in 1 case 3 months after the surgery.Postoperative traumatic arthritis occurred in 3 cases.The Gartland-Werley scores at the final follow-up were excellent in 18 cases,good in 5 cases and fair in 3 cases.Conclusion There is usually significant displacement of irregular fracture fragments on the articular surface in young adults with high-energy type C distal radius fractures.LCP combined with Kirschner wire fixation through volar,dorsal and radial approach can obtain personalized anatomic reduction of the fracture.It is one of the effective methods for treatment of unstable distal radius fractures. Key words: Radius fractures; Fracture fixation,internal; Young patient