Displaced distal radial fractures treated using volar locking plates: maintenance of normal anatomy.
BACKGROUND
The objective is to assess the ability of volar locking plates to maintain fracture reduction when used to treat dorsally displaced extra- and intra-articular distal radial fractures.


METHODS
This prospective study was conducted over an 12-month period. Consenting patients who had sustained a closed, dorsally displaced distal radial fracture, treated by open reduction and internal fixation using a volar distal radial locking plate were included in the study. Radial inclination, volar tilt, and ulnar variance were measured from radiographs taken at least 3 months after surgery and compared with radiographs of the uninjured side. Only two of the eight participating surgeons have a specialist interest in upper limb surgery.


RESULTS
Thirty-three patients were included in the study. There were 23 women and 10 men. The mean age was 49.5 years (range, 26-82 years). According to the Orthopaedic Trauma Association (OTA) classification, there were 19 Type A, 1 Type B, and 13 Type C fractures. The average restoration of volar tilt was 1-degree angle of under correction with a range of 7.3-degree angle of under correction to 3.7-degree angle of over correction, when compared with the uninjured side. The mean restoration of radial inclination was 1.9-degree angle of under correction with a range of 10-degree angle of under correction to 8.4-degree angle of over correction. As a group, the mean ulnar variance was 0 mm with a range of 2 mm of relative ulnar shortening to 3.5 mm of ulnar prominence when compared with the uninjured side.


CONCLUSIONS
In the hands of general trauma surgeons, the volar approach combined with the application of a suitable volar locking plate is a good treatment for restoring and maintaining the anatomy of dorsally displaced intra- and extra-articular distal radial fractures.
Stevenson
Iain
I
Orthopaedic Trauma Unit, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, United Kingdom. iainstevenson@doctors.net.uk
Carnegie
Carol A
CA
Christie
Eva M
EM
Kumar
Kapil
K
Johnstone
Alan J
AJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D015331:Cohort Studies; D005260:Female; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D053401:Palmar Plate; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome