title: Distal radius fractures with diaphyseal involvement: fixation with fixed angle volar plate.
abstract: BACKGROUND
  The purpose of this study was to evaluate the outcome of fractures of the distal radius with metaphyseal and diaphyseal involvement treated with fixed angle volar plates.
  
  
  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. Nonanatomical reduction was associated with the worst results (P = 0.0006). Flexion and extension averaged 62.8° and 73.8°, and pronation and supination 85.2° and 80.2°, 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.
  
  
  CONCLUSIONS
  Fixed angle volar plates were demonstrated to be a safe and efficient treatment in these challenging fractures.
authors: Centro Traumatologico Ortopedico-Roma-ASL RMC, U.O.C. Chirurgia della Mano, Microchirurgia e Reimpianto Arti, Rome, Italy. m.rampoldi@tin.it
authors: Michele
authors: M
authors: Rampoldi
authors: Dante
authors: D
authors: Palombi
authors: Donatella
authors: D
authors: Tagliente
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D018483:Diaphyses / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013580:Synostosis / Q000000981:diagnostic imaging*; D016896:Treatment Outcome; D055815:Young Adult