Relationship between the Length of Distal Locking Screws and Diaphyseal Screws in Volar Plate Fixation of Distal Radius Fractures

ABSTRACT

PURPOSE: To determine the relationship between the length of distal locking screws and diaphyseal screws in volar plate fixation of distal radius fractures. METHODS: A retrospective review was performed of 169 patients who underwent volar locking plate fixation for treatment of distal radius fractures. All patients received 2.4 mm LCP volar extra-articular distal radius plate (DePuySynthes). The length of the diaphyseal screw which was placed in the elongated hole was correlated with the length of a distal locking screw from radial most (D1) to ulnar most (D4). We also evaluated distal screw penetration of the dorsal cortex and plate removal rate. RESULTS: The length of the diaphyseal screw which was placed in the elongated hole strongly correlated with the length of a distal locking screw. Average D1 screw length was 2 mm longer than the diaphyseal screw, and average D2 screw length was 4 mm longer than the diaphyseal screw. D3 and D4 screw were 6 mm longer than the diaphyseal screw. Plate removal was necessary in 13 patients (8%) due to screw irritation. These patients had significantly longer screws than average. Flexor or extensor tendon ruptures did not occur in this cohort. CONCLUSION: The length of the distal locking screws can be estimated with the length of the diaphyseal screw. This information may help surgeons to select the adequate length of distal locking screws during volar plating of distal radius fractures.