More Evidence That Volar Locked Plating for Distal Radial Fractures Does Not Offer a Functional Advantage Over Traditional Treatment Options

Abstract

Distal radial fracture is one of the most frequent fractures in the upper extremity, with a multitude of treatment options. Despite the lack of evidence to justify the trend, there is a noticeable shift away from percutaneous fixation in favor of treatment with a volar locking plate1. While volar plates were designed to minimize complications such as tendon irritation2, their theoretical superiority over other treatment methods has yet to be demonstrated scientifically. In this prospective randomized study, Karantana et al. compared two techniques of fixation for distal radial fractures: open reduction and internal fixation (ORIF) with use of a volar locking plate and closed reduction and percutaneous pinning with or without external fixation. Functional outcome assessments were conducted at six weeks, twelve weeks, and one year. The authors found that scores of the Patient Evaluation Measure (PEM) and Quick DASH (a shortened version of the Disabilities of the Arm, Shoulder and Hand Outcome Measure) were significantly better for patients in the volar locking-plate group at six weeks, but these scores were similar between the groups by twelve weeks and at one year. In 2009, a similar study performed at two hospitals in our academic medical system also compared the results of ORIF with those of closed reduction and percutaneous pinning in a prospective randomized fashion. We found similar outcomes comparing the two treatment groups at one year3 …