Long term outcome of lower end radius fractures treated with locking plates

Abstract

Introduction: Fractures of distal end radius account for one sixth of all fractures that are seen and treated by orthopaedic surgeons. Increasing functional demand and improved methodologies of achieving and maintaining anatomical reduction, restoration of length, angulation and congruity of joint have generated renewed interest in addressing the anecdotal comments in more precise manner. Plating is a technique to restore and maintain the radial length and prevention of metaphyseal collapse. The focus of our interest in this study is to evaluate the outcome of plating in fractures of lower end of radius. Methods: We reviewed 36 patients treated for distal radius fractures using a plate. All patients were treated by volar plating using Henry’s volar approach for distal radius. Postoperative management included immediate finger movements, limb elevation and wrist immobilization for 4-6 weeks depending on fracture pattern and followed by wrist range of movement physiotherapy. Patients were followed for total 6 months-5 years. Radiographs of wrist joint were taken as well as movements in the form of dorsiflexion, palmerflexion, pronation, supination, radial deviation, ulnar deviation and hand grip were assessed at every follow up for all patients. At every follow up, patients were assessed using Gartland and Werley’s Demerit Scoring System for the result of plating of distal radius fracture. Patients were also evaluated for radiological outcome at immediate postoperative and at final follow up, in the form of radial length, radial inclination and volar tilt. Results: Fracture union had occurred in all patients at the mean time of follow-up of 9.5 weeks. On X-rays taken at the time of follow-up, 31 patients (86.10%) had achieved acceptable radial length that is radial shortening