J Hand Microsurg 2016; 08(03): 155-158
DOI: 10.1055/s-0036-1593731
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Titanium versus Stainless-Steel Plating in the Surgical Treatment of Distal Radius Fractures: A Randomized Trial

Sameer Shakir
1   Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
,
Sanjay Naran
1   Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
,
Mithun Neral
1   Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
,
Ronit Wollstein
1   Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
2   Division of Hand and Upper Extremity Surgery, Department of Orthopedic Surgery, Technion Israel Institute of Technology School of Medicine, Haifa, Israel
› Author Affiliations
Further Information

Publication History

13 May 2016

05 September 2016

Publication Date:
12 October 2016 (online)

Abstract

Our purpose was to compare postoperative complications and rate of plate removal in titanium and stainless-steel plating of distal radius fractures (DRF). Patients following DRF were randomly fixed with titanium or stainless-steel plates using the same plating system. Complications, second surgeries, and plate prominence were documented. A total of 41 patients were treated with stainless-steel and 22 with titanium plates. Average follow-up was 60 ± 5.6 months. There was no difference in demographics, fracture characteristics, or follow-up between the groups. Plate prominence was found in 50% of radiographs (mean distance: 1.4 mm). Four titanium plates and three stainless-steel plates were removed (11%). Mean time to plate removal was 18.4 ± 4.6 months. There was no difference in removal rates between the groups. Plate material and prominence, age, fracture comminution and smoking status were not associated with plate removal. Our results support using volar and dorsal plates regardless of the plate material.

 
  • References

  • 1 Protopsaltis TS, Ruch DS. Volar approach to distal radius fractures. J Hand Surg Am 2008; 33 (6) 958-965
  • 2 Rizzo M, Katt BA, Carothers JT. Comparison of locked volar plating versus pinning and external fixation in the treatment of unstable intraarticular distal radius fractures. Hand (NY) 2008; 3 (2) 111-117
  • 3 Rein S, Schikore H, Schneiders W, Amlang M, Zwipp H. Results of dorsal or volar plate fixation of AO type C3 distal radius fractures: a retrospective study. J Hand Surg Am 2007; 32 (7) 954-961
  • 4 Bell JS, Wollstein R, Citron ND. Rupture of flexor pollicis longus tendon: a complication of volar plating of the distal radius. J Bone Joint Surg Br 1998; 80 (2) 225-226
  • 5 Yamazaki H, Hattori Y, Doi K. Delayed rupture of flexor tendons caused by protrusion of a screw head of a volar plate for distal radius fracture: a case report. Hand Surg 2008; 13 (1) 27-29
  • 6 Cross AW, Schmidt CC. Flexor tendon injuries following locked volar plating of distal radius fractures. J Hand Surg Am 2008; 33 (2) 164-167
  • 7 Rikli DA, Regazzoni P. Fractures of the distal end of the radius treated by internal fixation and early function. A preliminary report of 20 cases. J Bone Joint Surg Br 1996; 78 (4) 588-592
  • 8 Thomas CV, McMillan KG, Jeynes P, Martin T, Parmar S. Use of a titanium cutting guide to assist raising the composite radial forearm free flap. Int J Oral Maxillofac Surg 2013; 42 (11) 1414-1417
  • 9 Wichlas F, Haas NP, Disch A, Machó D, Tsitsilonis S. Complication rates and reduction potential of palmar versus dorsal locking plate osteosynthesis for the treatment of distal radius fractures. J Orthop Traumatol 2014; 15 (4) 259-264
  • 10 Van Nortwick SS, Yao J, Ladd AL. Titanium integration with bone, welding, and screw head destruction complicating hardware removal of the distal radius: report of 2 cases. J Hand Surg Am 2012; 37 (7) 1388-1392
  • 11 Matzon JL, Kenniston J, Beredjiklian PK. Hardware-related complications after dorsal plating for displaced distal radius fractures. Orthopedics 2014; 37 (11) e978-e982
  • 12 Sinicropi SM, Su BW, Raia FJ, Parisien M, Strauch RJ, Rosenwasser MP. The effects of implant composition on extensor tenosynovitis in a canine distal radius fracture model. J Hand Surg Am 2005; 30 (2) 300-307
  • 13 Hayes JS, Welton JL, Wieling R, Richards RG. In vivo evaluation of defined polished titanium surfaces to prevent soft tissue adhesion. J Biomed Mater Res B Appl Biomater 2012; 100 (3) 611-617
  • 14 Couzens GB, Peters SE, Cutbush K , et al. Stainless steel versus titanium volar multi-axial locking plates for fixation of distal radius fractures: a randomised clinical trial. BMC Musculoskelet Disord 2014; 15: 74 DOI: 10.1186/1471-2474-15-74.
  • 15 Asadollahi S, Keith PP. Flexor tendon injuries following plate fixation of distal radius fractures: a systematic review of the literature. J Orthop Traumatol 2013; 14 (4) 227-234
  • 16 Ward CM, Kuhl TL, Adams BD. Early complications of volar plating of distal radius fractures and their relationship to surgeon experience. Hand (NY) 2011; 6 (2) 185-189
  • 17 Soong M, van Leerdam R, Guitton TG, Got C, Katarincic J, Ring D. Fracture of the distal radius: risk factors for complications after locked volar plate fixation. J Hand Surg Am 2011; 36 (1) 3-9
  • 18 Wei J, Yang TB, Luo W, Qin JB, Kong FJ. Complications following dorsal versus volar plate fixation of distal radius fracture: a meta-analysis. J Int Med Res 2013; 41 (2) 265-275
  • 19 Chou YC, Chen AC, Chen CY, Hsu YH, Wu CC. Dorsal and volar 2.4-mm titanium locking plate fixation for AO type C3 dorsally comminuted distal radius fractures. J Hand Surg Am 2011; 36 (6) 974-981
  • 20 Disseldorp DJ, Hannemann PF, Poeze M, Brink PR. Dorsal or Volar Plate Fixation of the Distal Radius: Does the Complication Rate Help Us to Choose?. J Wrist Surg 2016; 5 (3) 202-210
  • 21 Soong M, Earp BE, Bishop G, Leung A, Blazar P. Volar locking plate implant prominence and flexor tendon rupture. J Bone Joint Surg Am 2011; 93 (4) 328-335