Unstable distal radius fractures fixation with a 2.4 mm volar variable-angle locking plate: radiological and functional assessment

Abstract

Background: The main objective of this observational study was to evaluate the functional and radiological outcome of variable angle volar plates in intra-articular distal end radius fractures. Methods: Patients with distal end radius fractures (AO type 3C) treated operatively between Jan 2020 and Dec 2020 and then followed up for at least 12 months. A total of 32 patients (11 men and 21 women) with a mean age of 51.9 years were included in the study. The functional outcome was assessed by using modified Mayo wrist score (MMWS), disabilities of the arm, shoulder, and hand (DASH) score, wrist range of motion (ROM) and grip strength relative to the uninjured side and radiological assessment of radial height, volar tilt, and radial inclination. Results: MMWS and DASH scores improved postoperatively over time. Signs of radiographic union started around 12 weeks after surgery. The most common complication observed was finger and wrist stiffness, which was resolved with active wrist and finger movements. Non-union or hardware-related complications/ late complications such as tendon irritation/attrition were not observed with variable angle volar locking plates. Conclusions: Distal end radius fracture fixation with variable angle plate gives favourable radiological and clinical outcomes. These results can be owed to features such as low profile, variable locking, anatomical design and implant biomechanics. The surgeon determined angulation of the distal row of screw fixation may decrease the incidence of joint penetration and improve fixation of radial styloid and lunate facet stability.