DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20194246

Results of open reduction and fixed angle locked volar plate fixation for fracture lower end of radius

Gaurav Kumar, Varun Vijay

Abstract


Background: The fracture of lower end radius is the most common fracture of upper extremity encountered in practice. Intra-articular fractures of distal radius present a challenging task to the operating surgeon. Open reduction and internal fixation using volar fixed-angle plates has shown to be a valid treatment option for unstable, dorsally displaced distal radial fractures. The present study was undertaken to evaluate the functional outcome of unstable distal radius fractures treated with fixed angle volar locking plate.

Methods: The current study aimed at using fixed angle volar locking plate to treat unstable distal radius fractures. A total of 25 patients records were studied comprising of 19 males and 6 females with a mean of 44.5 years and followed up for a maximum of 1.5 year. Fractures were classified using the AO classification. The interpretation of functional outcome was done according to Mayo Wrist Score.

Results: At final functional assessment, according to the Mayo wrist score, the scores of 6 patients were excellent, 10 patients good, 8 patients satisfactory and 1 patient poor. No non-union was reported in any patients. 3 patients developed minor complications in the form of superficial infection, hypertrophic scar and reflex sympathetic dystrophy and 1 patient developed major complication in the form of deep infection.

Conclusions: Primary volar plate fixation of unstable distal radius fracture provides a stable construct that helps in early mobilization, better functional outcome and minimizes chances of complications and thereby is the treatment of choice for fracture distal end of radius.


Keywords


Distal radius fracture, Internal fixation, Fixed angle, Volar locking plate, Intra articular fracture

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References


Arora R, Gabl M, Gschwentner M, Deml C, Krappinger D, Lutz M. A comparative study of clinical and radiologic outcomes of unstable colles type distal radius fractures in patients older than 70 years: nonoperative treatment versus volar locking plating. J Orthop Trauma. 2009;23(4):237-42.

O'Neill TW, Cooper C, Finn JD, Lunt M, Purdie D, Reid DM, et al. Incidence of distal forearm fracture in British men and women. Osteoporos Int. 2001;12(7):555-8.

Cooney WP, Linscheid RL, Dobyns JH. External pin fixation for unstable Colles' fractures J Bone Joint Surg Am. 1979;61(6):840-5.

Arora R, Lutz M, Deml C, Krappinger D, Haug L, Gabl M. A prospective randomized trial comparing nonoperative treatment with volar locking plate fixation for displaced and unstable distal radial fractures in patients sixty-five years of age and older. J Bone Joint Surg Am. 2011;93(23):2146-53.

Trumble TE, Schmitt SR, Vedder NB. Factors affecting functional outcome of displaced intra-articular distal radius fractures. J Hand Surg Am. 1994;19(2):325-40.

Wolfe SW, Pike L, Slade JF III, Katz LD. Augmentation of distal radius fracture fixation with coralline hydroxyapatite bone graft substitute. J Hand Surg Am. 1999;24(4):816-27.

Medoff RJ. Fragment-specific fixation of distal radius fractures. Atlas of the Hand Clinics. 2006;11(2):163-74.

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

Musgrave DS, Idler RS. Volar fixation of dorsally displaced distal radius fractures using the 2.4-mm locking compression plates. J Hand Surg Am. 2005;30(4):743-9.

Fitoussi F, Ip WY, Chow SP. Treatment of displaced intra-articular fractures of the distal end of the radius with plates. J Bone Joint Surg Am 1997;79:1303-12.

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, LCP Study Group. Operative management of distal radial fractures with 2.4-millimeter locking plates. A multicenter prospective case series. J Bone Joint Surg Am. 2009;91(1):55-65.

Kamano M, Koshimune M, Toyama M, Kazuki K. Palmar plating system for Colles' fractures-a preliminary report. J Hand Surg. 2005;30:750-5.

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

Rohit A, Martin L, Alfred H, Dietmar K, David E, Markus G. Complications following internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma. 2007;21:316-22.

Simic PM, Robison J, Gardner MJ, Gelberman RH, Weiland AJ, Boyer MI. Treatment of distal radius fractures with a low-profile dorsal plating system: an outcomes assessment. J Hand Surg. 2006;31:382-6.

Crenshaw AH Jr. Fractures of shoulder, arm, and forearm. In: Campbellā€²s Operative Orthopaedics. Part XV. 11 th ed., Vol. 3. Ch. 54. Philadelphia: Mosby Inc.; 2008: 3447-3449.

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.

Chung KC, Watt A, Kotsis S, Hase S, Myra KH. Treatment of unstable distal radius fractures with volar locking compression plate. The J Bone Joint Surg. 2006;88(12):2687-94.

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

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.