ABSTRACT
Background: Fractures of the distal radius involving the metaphyseal and diaphyseal junction are commonly the result of high energy trauma, and represent a challenge for the orthopedic surgeon. Fractures are often comminuted: optimal reduction, restoration of normal radial length, and a correct radioulnar relationship may be difficult to achieve. Only a few reports in the literature have studied these lesions, and the best treatment approach is still the source of debate. Aims & Objective: To evaluate the outcome of fractures of the distal radius with metaphyseal and diaphyseal involvement treated with fixed angle volar plates. Materials and Methods: Twenty-one patients with fracture of the radius involving the diaphyseal, metaphyseal and epiphyseal parts were treated with fixed angle plate fixation through an extended volar Henry’s approach. Circle wire loops, screws and intrafocal wire fixations were associated in 12 cases. Coexisting ulnar fractures were fixed with plates or K-wires in 8 cases. All patients were prospectively followed using radiographs, physical examination, and DASH (Disabilities of the Arm, Shoulder and Hand) scores. Results: All fractures except one, which needed a secondary bone graft to achieve consolidation, united by an average of 90 days. One case developed a radioulnar synostosis. Radiographs showed optimal reduction in 17 of 21 cases, with restoration of radial length in all cases and a neutral average ulnar variance. Non-anatomical reduction was associated with the worst results (P = 0.0006). Flexion and extension averaged 62.8 degree and 73.8 degree and pronation and supination 85.2degree and 80.2degree respectively. The average DASH scores were 30 points at 3 months, 14 points at 6 months, and 6.7 points at the time of final follow-up (at an average of 11 months). According to the Mayo wrist rating system, 14 patients showed excellent results, 5 showed good results, and 2 showed fair results. Conclusion: Fixed angle volar plates were demonstrated to be a safe and efficient treatment in these challenging fractures.
ABSTRACT
PURPOSE: To compare the outcomes of distal radius fractures in a fixed-angle volar locking plate group and variable-angle volar locking plate group. MATERIALS AND METHODS: Forty-one patients observed at least 6 months after surgery were included in this retrospective study. We used the range of motion, visual analogue scale score, Disabilities of the Arm, Shoulder and Hand Questionnaire score, and radiologic findings to measure the clinical results. RESULTS: No differences in clinical results or radiologic results were noted between the fixed-angle volar locking plate group and variable-angle volar locking plate group. CONCLUSION: We believe that it is important to minimize complications by using appropriate screws and plates according to the fracture type, though no differences in the surgical outcome were noted between the fixed-angle volar locking plate group and variable-angle volar locking plate group with distal radius fracture.