Surgical management of fractures of distal end radius with open reduction and internal fixation using volar locking compression plate

Abstract

Backgrounds and Objectives: Fractures of distal end of the radius are one of the most common injuries which lead to approximately 1/6th of all fractures which are observed and treated.Failure to achieve and also to maintain anatomic restoration may lead to various deformities and disabilities, poor functional outcome (usually seen with cast immobilization of intraarticular fractures)Later studies have advised operative intervention with conventional T buttress plates, and more recently volar locking compression plates whose mechanical advantage justifies its vast usage. The principle of the Locking Compression Plate is to have rigid fixation close to the bone and under the soft tissue envelope. Locking Compression Plates are anatomically designed plates to maintain alignment and to prevent collapse of the fracture fragment.Methods: This study is a prospective, time bound, hospital based study that was conducted in kempegowda institute of medical sciences and research centre, Bangalore between October 2018 and May 2020. The study included a total of 30 cases of distal end radius fractures that were operated with open reduction and internal fixation with volar Locking Compression Plate (volar LCP).The fractures were classified according to Frykmann classification and were followed up at regular intervals. Functional outcome was assessed using the Gartland and Werley demerit scoring at each follow up visit.Results: Our study revealed nearly half of the study population with excellent outcome (47%), good and fair outcomes were noted among 40% and 13% respectively while none of the patients had poor outcome.Most fractures united by 12 weeks. Complications associated were stiffness, arthritis and EPL tendon irritation.Conclusion: The present study demonstrates well to excellent results in the majority of patients based on G&W functional outcome evaluation after locking plate fixation of the lower end distal radius with lower rate of complications.