Surgical treatment of unstable distal radius fractures with volar locking plates

Abstract

BackgroundSurgical treatment of unstable distal radius fractures does not always yield a satisfactory outcome. The several surgical strategies available have problems associated with them. This study was undertaken to determine if volar locking plate fixation could be useful for treating unstable distal radius fractures. MethodsThis retrospective follow-up study assessed 24 fractures in 24 patients with unstable distal radius fractures surgically treated with one of three volar locking plate systems. According to the AO classification system, 7 patients had type A3 fractures, 5 patients had type C2 fractures, and the remaining 12 patients had type C3 fractures. Radiographic measurements included volar tilt, radial inclination, and ulnar variance. Clinical outcomes were evaluated by active range of motion of the wrist and forearm, grip strength, Saito’s wrist score, and the Japanese Society for Surgery of the Hand version of the Disabilities of the Arm, Shoulder, and Hand questionnaire (JSSH version of the DASH). ResultsAt the time of final follow-up (5 months minimum) the mean volar tilt was 8.1°, radial inclination was 20°, and ulnar variance was 0.4mm. Mean wrist extension measured 61°, wrist flexion 55°, radial deviation 23°, ulnar deviation 35°, pronation 87°, and supination 87°. Grip strength recovered to a mean of 84% of the grip strength in the contralateral limb for patients who had injured their dominant hand and to a mean of 73% for patients who had injured their nondominant hand. Saito’s wrist score calculations revealed 20 excellent and 4 good results. The mean DASH disability/symptom score was 9.9 points, and the mean DASH work module score was 8.2 points. ConclusionsThe present study demonstrated that unstable distal radius fractures could be successfully treated with volar locking plate systems.