Study of clinicoradiological and functional outcomes in intraarticular distal end radius fractures managed by volar locking plate

Pravin Agrawal, Samadhan Mundhe, Sajal Mitra


Background: Various modalities of fixation are available for management of distal end radius fractures. Assessment of the functional and radiological outcomes of intra-articular distal end radius fractures managed with volar locking plate was attempted with the present study.

Methods: In this prospective interventional study, thirty adult patients with closed distal radius fractures with intra-articular extension were comprehensively evaluated and managed. Open reduction and internal fixation (ORIF) was performed via volar approach (modified Henry`s approach) using 2.7mm volar locking compression plates (LCPs). Patients were followed up at 2 weeks, 1 month, 3 months and 6 months after surgery. The patients were evaluated functionally by Mayo score and radiologically by Lidstrom classification.

Results: There were 18 (60%) patients having excellent, 8 (26.7) good, 2 (6.7%) fair and 2 (6.7%) with poor result according to Mayo scoring. According to Lidstrom scoring, at the last follow up, 16 (53.3%) patients had excellent, 11 (36.7%) patients good, 2 (6, 7%) patients fair and 1(3.3%) patient had poor result. The functional status of the patient improved significantly from at 1month (20±3.47) to 6 months post-operative follow up (23.67±2.91). The mean range of motion improved significantly at 1 month, 6 months and last post-operative follow-up.

Conclusions:Volar locking plate gives good to excellent clinico-radiological and functional outcomes in most of the fractures of the distal end radius with intraarticular extension. 



Distal end radius fracture, Volar locking plate, Radiological outcome, Functional outcome

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Chung KC, Spilson SV. The frequency and epidemiology of hand and forearm fractures in the United States. J Hand Surg. 2001;26(5):908-15.

Boyd LG, Horne JG. The outcome of fractures of the distal radius in young adults. Injury. 1988;19(2):97-100.

Fitoussi F, Ip WY, Chow SP. Treatment of displaced intra-articular fractures of the distal end of the radius with plates. JBJS. 1997;79(9):1303-12.

McQueen M, Caspers J. Colles fracture: does the anatomical result affect the final function? The Journal of bone and joint surgery. British Vol. 1988;70(4):649-51.

Osada D, Viegas SF, Shah MA, Morris RP, Patterson RM. Comparison of different distal radius dorsal and volar fracture fixation plates: a biomechanical study. J Hand Surg. 2003;28(1):94-104.

Rausch S, Klos K, Gras F, Skulev HK, Popp A, Hofmann GO, Mückley T. Utility of the cortical thickness of the distal radius as a predictor of distal-radius bone density. Arch Trauma Res. 2013;2(1):11.

Arora R, Lutz M, Hennerbichler A, Krappinger D, Espen D, Gabl M. Complications following internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma. 2007;21(5):316-22.

Jupiter JB, Marent-Huber M. Operative management of distal radial fractures with 2.4-millimeter locking plates: a multicenter prospective case series. J Bone Joint Surg. 2009;91(1):55-65.

Orbay JL, Fernandez DL. Volar fixation for dorsally displaced fractures of the distal radius: a preliminary report. J Hand Surg. 2002;27(2):205-15.

Müller ME, Allgöwer M, Allgower M, Schneider R, Willenegger H. Manual of internal fixation: techniques recommended by the AO-ASIF group. Springer Science & Business Media; 1991;87-90.

Smith DW, Henry MH. Volar fixed-angle plating of the distal radius. JAAOS. J Am Acad Orthop Surg. 2005;13(1):28-36.

Lamey DM, Fernandez DL. Results of the modified Sauve-Kapandji procedure in the treatment of chronic posttraumatic derangement of the distal radioulnar joint. JBJS. 1998;80(12):1758-69.

Wong DL, Baker CM. Pain in children: comparison of assessment scales. Pediatr Nurs. 1988;14(1):9-17.

Bellace JV, Healy D, Besser MP, Byron T, Hohman L. Validity of the Dexter Evaluation System's Jamar dynamometer attachment for assessment of hand grip strength in a normal population. J Hand Therap. 2000;13(1):46-51.

Gauresh V. Distal end radius fractures: evaluation of results of various treatments and assessment of treatment choice. Chinese J Traumatol. 2014;17(4):214-9.

Levin SM, Nelson CO, Botts JD, Teplitz GA, Kwon Y, Serra-Hsu F. Biomechanical evaluation of volar locking plates for distal radius fractures. Hand. 2008;3(1):55-60.

Arora R, Gabi M, Gschwentner M, Deml C, Krappinger D. A comparative study of clinical and radiological outcome of unstable colles type distal radius fracture in patients older than 70 years: non-operative treatment versus volar locking plate. J Orthop Trauma. 2009;23:237-42.

Ruch DS, Papadonikolakis A. Volar versus dorsal plating in the management of intra-articular distal radius fractures. J Hand Surg [Am]. 2006;31:9-16.

Jose A, Surangi SM, Deniese PN, Babu AT, Rengaswamy K, Najimudeen S. Unstable distal radius fractures treated by volar locking anatomical plates. J Clin Diag Res. 2017;11(1):56-60.

Kilic A, Kabukcuoglu Y, Ozkaya U, Gul M, Sokucu S, Ozdogan U. Volar locking plate fixation of unstable distal radius fractures. Acta Orthop Traumatol Turc. 2009;43(4):303-8.

Adani R, Tarallo L, Amorico MG, Tata C, Atzei A. The treatment of distal radius articular fractures through LCP system. Hand Surg. 2008;13(02):61-72.

Anakwe RE, Khan LA, Cook RE, McEachan JE. Locked volar plating for complex distal radius fractures: Patient reported outcomes and satisfaction. J Orthop Surg Res. 2010;5(1):51.

Kotian P, Mudiganty S, Annappa R, Austine J. Radiological Outcomes of Distal Radius Fractures Managed with 2.7 mm Volar Locking Plate Fixation-A Retrospective Analysis. Journal of clinical and diagnostic research: J Clin Diag Res. 2017;11(1):112-116..

Lattmann T, Meier C, Dietrich M, Forberger J, Platz A. Results of volar locking plate osteosynthesis for distal radial fractures. J Trauma Acute Care Surg. 2011;70(6):1510-8.