Comparison of Functional Outcome After Volar Plate Fixation With 2.4-mm Titanium Versus 3.5-mm Stainless-Steel Plate for Extra-Articular Fracture of Distal Radius

Purpose

Open reduction and locked volar plate and screw fixation is a popular treatment method for extra-articular distal radius fractures with dorsal metaphyseal comminution. In this study, we compared the use of a titanium 2.4-mm precontoured plate with that of a stainless-steel oblique 3.5-mm T-shaped plate to test the null hypothesis that there would be no difference in wrist function or upper extremity–specific health status in the internal fixation of AO-type A3.2 distal radius fractures.

Methods

We retrospectively analyzed 24 patients treated with a 2.4-mm titanium plate and 38 patients treated with a 3.5-mm stainless-steel plate for an extra-articular and dorsally angulated distal radius fracture, from data gathered in a prospective cohort study of plate and screw fixation of distal radius fractures. The 2 cohorts were analyzed for differences in motion, grip strength, pain, Gartland and Werley score, Disabilities of the Arm, Shoulder, and Hand score, and Short Form-36 score at 6, 12, and 24 months of follow-up. Group differences and their change over time were determined using regression analysis and the likelihood ratio test.

Results

There were no significant differences in wrist function and arm-specific health status between patients treated with a 2.4-mm plate and those treated with a 3.5-mm plate at 6, 12, or 24 months of follow-up. However, we observed a trend toward greater wrist flexion at 1 year (66° vs 55°; p=.07) and greater flexion–extension arc (137° vs 123°; p=.08) and pronation–supination arc (172° vs 160°; p=.07) at 24 months after surgery in patients treated with a 2.4-mm plate.

Conclusions

Patients with a dorsally angulated extra-articular distal radius facture can expect similar results when treated with either a precontoured 2.4-mm titanium plate or a 3.5-mm stainless-steel T-shaped plate.

Type of study/level of evidence

Therapeutic III.

Key words: Distal radius fracture, open reduction and internal fixation, plate and screws, outcome