The effect of varying volar plate positioning on the treatment outcomes of internal fixation of type C distal radial fractures

Abstract

Objective To analyze the effect of plate positioning (in relation to the watershed line) on the prognosis of volar internal fixation of type C distal radius fractures. Methods A retrospective review was conducted of 53 patients with type C (AO classification) distal radius fractures treated with internal fixation from April 2010 to April 2013. Based on the standard lateral radiograph, the relationship of the plate and the watershed line was classified as level 0, level 1, and level 2 according to Soong grading system. Radiographic parameters including teardrop angle, volar inclination, ulnar inclination and ulnar variance, wrist motions such as flexion, dorsiflexion, radial deviation, ulnar deviation, pronation and supination, grip strength and DASH scores were used to evaluate the function of the wrist. Postoperative complications were also recorded. These results were compared among patients with different Soong levels. Results These patients had an average of 21.1 months′ follow-up (range, 12 to 39 months). Radiographs showed that all the fractures had healed. There were no complications associated with the internal fixation. No statistically significant differences were seen in the measurements among different Soong levels. Conclusion In treatment of type C distal radius fractures with volar plate internal fixation, position of the plate does not affect the functional recovery and radiographic parameters. However if conditions permit, the plate should be placed proximal to the watershed line. Key words: Radius fractures; Fracture fixation, internal; Soong grading system