Post-operative complications of displaced unstable distal end radius fracture treated by volar plating
Keywords:Radius fracture, Volar plating, Modified Gartland, Werley score
Background: Fracture of the distal radius (DRF) is one of the most common fractures present in emergency. The most common operative treatments of these fractures are open reduction and internal fixation with volar locking plates. The incidents and types of complications associated with the use of these operations is an ongoing process till date. The objective of the study was to find demographic profile of patients of displaced unstable distal end radius fracture, and to study the post-operative complications among above patients treated by volar plating.
Methods: We performed a prospective study documenting types of complications and their occurrence in a group of patients who received open reduction and internal fixation. Our definition of a complication was a case in which the patient had one or more complications which required an intervention medical or surgical.
Results: A total of 33 patients were included, most of the cases, (63.63%) were from the age group 21-40 years. We had 4 cases (12. 12%) females, and 29 cases (87.88%) males. Post-operative complications were noted in 7 individuals 22.2 % and no complications noted in 26 cases (78.8%). In 30 cases there was no any deformity found in postoperative one year follow up, 2 patients develop prominent ulnar styloid found in follow up of one year ,and 1 residual dorsal tilt found after one year.
Conclusions: Our finding that 22.2% suffer from complication when treated using a volar locking plate must be taken into consideration when surgeons choose between conservative or operative treatment for DRF treatment. A few other studies have looked at the incidents of complications and have reported similar results.
Meena S, Sharma P, Sambharia AK, Dawar A. Fractures of distal radius: an overview. J Fam Med Prim Care. 2014;3(4):325.
Data extraction from Dansk Fraktur Database. Beginning of May, 2014.
Berglund L, Messer T. Complications of volar plate fixation for managing distal radius fractures. J Am Acad Orthop Surg. 2009;17:369-77.
Esenwein P, Sonderegger J, Gruenert J, Ellenrieder B, Tawfik J, Jakubietz M. Complications following palmar plate fixation of distal radius fractures: a review of 665 cases. Arch Orthop Trauma Surg 2013;133:1155-62.
Rizzo M, Katt B, Carothers J. Comparison of locked volar plating versus pinning and external fixation in the treatment of unstable intraarticular distal radius fractures. Hand (NY). 2008;3:111-7.
Ward C, Kuhl T, Adams B. Early complications of volar plating of distal radius fractures and their relationship to surgeon experience. Hand (NY). 2011;6:185-9.
Ruch D, Papadonikolakis A. Volar versus dorsal plating in the management of intra-articular distal radius fractures. J Hand Surg Am. 2006;31:9-16.
Orbay JL, Fernandez DL. Volar fixation for dorsally displaced fracture of the distal radius: a preliminary report. J Hand Surg Am. 2002;27(2):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.
Rozental TD, Blazar PE. Functional outcome and complications after volar plating for dorsally displaced, unstable fractures of the distal radius. J Hand Surg. 2006;31(3):359-65.
Orbay JL, Fernandez DL. Volar fixed-angle plate fixation for unstable distal radius fractures in the elderly patient. J Hand Surg Am. 2004;29(1):96-102.
Tarallo L, Mugnai R, Zambianchi F, Adani R, Catani F. Volar plate fixation for the treatment of distal radius fractures: analysis of adverse events. J Orthop Trauma. 2013;27:740-74.
Kamano M, Honda Y, Kazuki K, Yasuda M. Palmar plating for dorsally displaced fractures of the distal radius. Clin Orthop Relat Res. 2002;397:403-8.
Khatri K, Sharma V, Farooque K, Tiwari V. Surgical treatment of unstable distal radius fractures with a volar variable-angle locking plate: clinical and radiological outcomes. Arch Trauma Res. 2016;5(2).
Gogna P, Selhi HS, Singla R, Devgan A, Magu NK, Mahindra P, Yamin M. Dorsally comminuted fractures of the distal end of the radius: Osteosynthesis with volar fixed angle locking plates. ISRN Orthopedics. 2013;8.