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J Wrist Surg 2013; 02(03): 247-254
DOI: 10.1055/s-0033-1350086
Scientific Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Volar Plate Fixation of Intra-Articular Distal Radius Fractures: A Retrospective Study

Margaret W. M. Fok
1   Department of Orthopaedic Surgery and Hand Surgery, Lindenhof Hospital, Bern, Switzerland
,
Melissa A. Klausmeyer
1   Department of Orthopaedic Surgery and Hand Surgery, Lindenhof Hospital, Bern, Switzerland
,
Diego L. Fernandez
1   Department of Orthopaedic Surgery and Hand Surgery, Lindenhof Hospital, Bern, Switzerland
,
Jorge L. Orbay
2   The Miami Hand and Upper Extremity Institute, Miami, Florida
,
Alex Lluch Bergada
3   Hand Surgery Unit, Vall d'Hebron University Hospital, Barcelona, Spain
› Author Affiliations
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Publication History

Publication Date:
05 September 2013 (online)

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Abstract

Background Intra-articular fractures of the distal radius represent a therapeutic challenge as compared with the unstable extra-articular fractures. With the recent development of specifically designed internal fixation materials for the distal radius, treatment of these fractures by fragment-specific implants using two or more incisions has been advocated.

Purpose The purpose of this study was to investigate the efficacy of a fixed-angle locking plate applied through a single volar approach in maintaining the radiographic alignment of unstable intra-articular fractures as well as to report the clinical outcomes. We only excluded those with massive comminution, as is discussed in greater detail in the text.

Patients and Methods This is a multicentered, retrospective study involving three hospitals situated in Spain, Switzerland, and the United States. In the period between January 2000 and March 2006, 97 patients with 101 intra-articular distal radius fractures, including 13 volarly displaced and 88 dorsally angulated fractures were analyzed. Over 80% were C2/C3 fractures, based on the AO classification. 16 open fractures were noted.

Results With an average follow-up of 28 months (range 24–70 months), the range of movement of the wrist was very satisfactory, and the mean grip strength was 81% of the opposite wrist. The Disabilities of the Arm, Shoulder, and Hand (DASH) score was 8. The complications rate was < 5%, including loss of reduction in two patients. All fractures healed by 3 months postinjury.

Conclusions Irrespective of the direction and amount of initial displacement, a great majority of intra-articular fractures of the distal radius can be managed with a fixed-angle volar plate through a single volar approach.

Level IV retrospective case series

Keywords

distal radius fractures - volar plate - internal fixation - intra-articular fractures

Notes

This study does not receive any financial support from any company or government body.


None of the cases, illustrations, images, and figures given contains any identifiable patient information.


 

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