Evaluation of volar locking plate fixation for management of intra-articular fractures of distal end of radius


  • Ritesh S. Pathak Dept. of Orthopedics, Indian Institute of Medical Sciences and Research, Warudi, Dist. Jalna, Maharashtra, India
  • Athar Ahemad Dept. of Orthopedics, Indian Institute of Medical Sciences and Research, Warudi, Dist. Jalna, Maharashtra, India
  • Jitendra Pimple Dept. of Orthopedics, AIMS Hospital, Aurangabad, Maharashtra, India




Volar locking plate, Distal end radius fracture, Green and O’Brien scoring


Background: With the increase in high velocity trauma, the incidence of intra-articular fractures of distal end of radius, particularly in adults- the working class of society is increasing. Normal functioning of wrist is of paramount importance for all activities of daily living and working. The present study was undertaken to evaluate the results of using volar locking plate for fixation of intra-articular fractures of distal end radius, with emphasis on return to pre-injury employment assessment.

Methods: It is a combined prospective and retrospective study from January 2013 to June 2016. Twenty patients of intra-articular fractures of distal end of radius (AO type B2 and B3) were treated with volar locking plate through volar approach. The patients were regularly followed up for one year. The assessment of pain, range of motion, activity and grip strength were scored by Green and O’Brien’s system.

Results: According to scoring system of Green and O’Brien the patients were assessed at 1 year follow up. 17 patients (85%) showed excellent results (scores 90-100). 2 patients (10%) showed good result (scores 80-89) while 1 patient (5%) had fair outcome (score 65-79). No patient had poor result (score less than 65). 19 patients (95%) returned to their pre-injury employment at 1 year.

Conclusions: Open reduction and internal fixation with volar locking plate is reliable and excellent methods of management of intra-articular fracture of distal end of radius especially shear type of injury (AO type B2 and B3) in adults. 


Jupiter JB. Fractures of the distal end of radius. JBJS Am. 1991;73:461-9.

Lichtman DM, Bindra RR, Boyer MI, Putman MD, Ring D. Distal radius work group: the treatment of distal radius fractures. J Am Acad Orthop Surg. 2010;18:180-9.

Handoll HH, Huntley JS, Madhok R. External Fixation versus conservative treatment for distal radius fractures in adults. Cochrane Database Syst Rev. 2007;18(3):CD006194.

Slustsky DJ. External Fixation of distal radius fractures. J Hand Surg Am. 2007;32:1624-34.

Chung KC, Watt AJ, Kotsis SV, Margaliot Z, Haase SC, Kim HM. Treatment of unstable distal radial fractures with volar locking plate system. J Bone Jt Surg Am. 2006;88:2687-94.

Schnall SB, Kim BJ, Abramo A, Kopylov P. Fixation of distal radius fractures using a fragment-specific system. Clinical Orthop. 2006;445:51-7.

Konstantinos CX, Dionysios AV, Konstantinos JK. Classifying fractures of distal radius: Impossible or Unnecessary? Review of the literature and proposal of a grouping System. Med Sci Monit. 2009;15(3):67-74.

Doi K, Hattori Y, Otsuka K, Abe Y, Yamamoto H. Intra-articular fractures of distal aspect of radius: arthroscopically assisted reduction compared with open reduction and internal fixation. J Bone Joint Surg (Am). 1999;81:1093-110.

Rader CP, Rauber C, Rehm KE, Koebke J. Internal fixation of the distal radius. A comparative, experimental study. Arch Orthop Trauma Surg. 1995;114:340-3.

Hove LM, Nilsen PT, Furnes O, Oulie HE, Solhem E, Molster AO. Open reduction and internal fixation of displaced intra-articular fractures of the distal radius. Thirty-one patients followed for 3-7 years. Acta Orthop Scand. 1997;68:59-63.

Drobetz H, Kutscha-Lissberg E. Osteosynthesis of distal radial fractures with a volar locking screw plate system. Int Orthop (SICOT). 2003;27:1-6.

Wong KK, Chan KW, Kwok TK, Mak KH. Volar fixation of dorsally displaced distal radial fracture using locking compression plate. J Orthop Surg. 2005;13(2):153-7.

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

Ho AWH, Ho ST, Koo SC. Hand numbness and carpal tunnel syndrome after volar plating of distal radius fracture. Hand. 2011;6(1):34-8.






Original Research Articles