title: Results of volar locking plating for unstable distal radius fractures.
abstract: OBJECTIVE
  The aim of this study was to analyze the complications and functional and radiographic results of volar locking plating in the treatment of unstable distal radius fractures.
  
  
  METHODS
  Forty-six patients (mean age: 48.7 years) with Type C distal radius fractures were treated with volar locking plates and evaluated over a mean follow-up period of 19 months. Range of motion, strength, DASH questionnaire and MAYO wrist score were assessed. Shortening, inclination and palmar tilt were recorded on standard radiographs and tenosynovitis and tendon ruptures were assessed using ultrasound. The uninjured wrists were examined as controls. Statistical analysis was made using t-tests.
  
  
  RESULTS
  All fractures achieved union. Postoperative MAYO scores revealed 14 excellent results, 11 good, 20 satisfactory and one poor result. The mean postoperative DASH score was 15.9 (range: 0 to 72). Active wrist motion averaged 52.3 degrees of flexion, 57.7 degrees of extension, 79.2 degrees of supination and 79.3 degrees of pronation. Mean grip strength was 82% of the uninjured side and mean loss of radial inclination was 0.6 degrees and palmar tilt was 6.6 degrees as compared to normal side. Carpal tunnel syndrome was observed in one patient, flexor tenosynovitis in one patient, extensor tendon rupture in one patient and extensor tenosynovitis in eleven patients. Functional and clinical limitations were most evident in the patients with tendon tear or tenosynovitis.
  
  
  CONCLUSIONS
  Fixation of unstable distal radius fractures with volar locking plates provides sufficient stability, and satisfactory clinical outcomes. However, these systems have complication potential that may limit better outcomes.
authors.affiliation: Hand Microsurgery Orthopaedics and Traumatology Hospital, İzmir, Turkey. tssugun@hotmail.com
authors.forename: Tahir Sadık
authors.initials: TS
authors.lastname: Sügün
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Gürbüz
authors.forename: Kemal
authors.initials: K
authors.lastname: Ozaksar
authors.forename: Tulgar
authors.initials: T
authors.lastname: Toros
authors.forename: Murat
authors.initials: M
authors.lastname: Kayalar
authors.forename: Emin
authors.initials: E
authors.lastname: Bal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates / Q000706:statistics & numerical data*; D003100:Colles' Fracture / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods; D018737:Hand Strength; D006801:Humans; D007593:Joint Instability / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D053401:Palmar Plate / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*