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
Received 19 April 2009; accepted 24 November 2009. published online 08 February 2010.
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.
Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, USA; BG-Unfallklinik, Ludwigshafen, Germany; and Marta Marent-Huber, AO Clinical Investigation and Documentation, Dübendorf, Switzerland
Corresponding author: David Ring, MD, PhD, Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center 2100/2C, 55 Fruit Street, Boston, MA 02114
The study was supported by the Arbeitsgemeinschaft für Osteosynthesefragen Center for Investigation and Documentation. D.R. received unrestricted research grants from Small Bone Innovations, Smith and Nephew, Wright Medical, Acumed, and Tornier. D.R. received royalties from Hand Innovation and is a paid consultant for Smith and Nephew, Wright Medical, Acumed, and Tornier.
ABSTRACT