Open reduction and internal fixation of unstable dorsally displaced distal radius fractures using a fixed-angle volar plate with locking screws

Abstract

Purpose To assess the medium-term results of (DVR) fixed-angle anatomic plates in the treatment of unstable distal radius fractures. Materials and methods Retrospective study of 93 dorsally displaced unstable distal radius fractures, treated by means of open reduction with a volar approach and DVT plate fixation. Mean age was 46 years and mean follow-up was 13 months. A clinicalfunctional evaluation was carried out for all patients by measuring range of movement, degree of pain, surgical outcomes (using the Gartland–Werley and Green-O’Brien scales) and degree of disability as reflected by the DASH scale. Radiographs were used to assess volar and radial inclination angles as well as radial height, articular step-offs and radiocarpal arthritis. The last X-ray follow-up value obtained was used to carry out a statistical comparison with immediate pre- and post-operative radiographs. Results All our fractures but one healed in a mean 8.2-week period. The radiological parameters studied showed that the mean correction achieved was within normal values and now significant variations occurred at the end of follow-up (p≤0.05). Some degree articular step-off persisted in 12 fractures. 73,33% of patients were pain free. The score of excellent and good results were higher than 80% according to the scales used, and the disability index was low (18.32) according to the DASH score. Conclusions The use of fixed-angle volar plates with locking screws in a safe and efficient treatment for dorsally displaced instable distal radius fractures. We think these constitute an excellent alternative for the treatment of this kind of injury.