Study of clinicoradiological and functional outcomes in intraarticular distal end radius fractures managed by volar locking plate
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20192092Keywords:
Distal end radius fracture, Volar locking plate, Radiological outcome, Functional outcomeAbstract
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.
References
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.