Purpose
Despite the recent popularity of volar plating for dorsally displaced distal radius
fractures there is a paucity of data documenting the results of this treatment method.
The purpose of this study was to determine the functional outcome of patients treated
with volar fixed-angle plating for dorsally displaced, unstable distal radius fractures.
Methods
We reviewed the records of all patients treated at our institution with internal fixation
using volar plates for dorsally displaced, comminuted distal radius fractures. Patients
with follow-up periods shorter than 12 months were excluded from the study. Outcomes
were evaluated at the latest follow-up examination with the Disabilities of the Arm,
Shoulder, and Hand and the Gartland and Werley scoring systems.
Results
We studied 41 patients with a mean age of 53 years. The average follow-up period was
17 months. All fractures were stabilized with volar locking plates. Radiographs in
the immediate postoperative period showed a mean radial height of 11 mm, mean radial
inclination of 21°, and mean volar tilt of 4°. At fracture healing the mean radial
height was 11 mm, mean radial inclination was 21°, and mean volar tilt was 5°. The
average score on the Disabilities of the Arm, Shoulder, and Hand questionnaire was
14 and all patients achieved excellent and good results on the Gartland and Werley
scoring system, indicating minimal impairment in activities of daily living. Nine
patients experienced postoperative complications. There were 4 instances of loss of
reduction with fracture collapse, 3 patients required hardware removal for tendon
irritation, 1 patient developed a wound dehiscence, and 1 patient had metacarpophalangeal
joint stiffness.
Conclusions
Patients with unstable, dorsally displaced fractures of the distal radius treated
with volar fixed-angle devices have good or excellent functional outcomes despite
a high complication rate. When compared with previous reports on dorsal plating volar
plates appear to have a higher incidence of fracture collapse but a lower rate of
hardware-related complications. Complex fracture patterns thus mandate a careful and
individualized approach.
Type of study/level of evidence
Therapeutic, Level III.
Key words
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Article info
Publication history
Accepted:
October 25,
2005
Received:
September 27,
2005
Footnotes
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Identification
Copyright
© 2006 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
