title: Radiographic outcomes of volar locked plating for distal radius fractures.
abstract: OBJECTIVE
  To assess the ability of volar locked plating to achieve and maintain normal radiographic parameters for articular stepoff, volar tilt, radial inclination, ulnar variance, and radial height in distal radius fractures.
  
  
  METHODS
  We performed a retrospective review of 185 distal radius fractures that underwent volar locked plating with a single plate design over a 5-year period. We reviewed radiographs and recorded measurements for volar tilt, radial inclination, ulnar variance, radial height, and articular stepoff. We used logistic regression to determine the association between return to radiographic standard norms and fracture type.
  
  
  RESULTS
  At the first and final postoperative follow-up visits, we observed articular congruence less than 2 mm in 92% of fractures at both times. Normal volar tilt (11°) was restored in 46% at the first follow-up and 48% at the final one. Radial inclination (22°) was achieved in 44% at the first follow-up and 43% at the final one, and ulnar variance (01 ± 2 mm) was achieved in 53% at the first follow-up and 53% at the final one. In addition, radial height (14 ± 1mm) was restored in 14% at the first follow-up and 12% at the final one. More complex, intra-articular fractures (AO class B and C and Frykman types 3, 4, 7, and 8) were less likely to be restored to normal radiographic parameters. However, because of the small sample size for some fracture types, it was difficult to discover significant associations between fracture type and radiographic outcome.
  
  
  CONCLUSIONS
  Volar locked plating for distal radius fractures achieved articular stepoff less than 2 mm in most fractures but only restored and maintained normal radiographic measurements for volar tilt, radial inclination, and ulnar variance in 50% of fractures. The ability of volar locked plating to restore and maintain ulnar variance and volar tilt decreased with more complex intra-articular fracture types.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Orthopaedics and Rehabilitation, the Division of Cancer Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Mignemi
authors.forename: Ian R
authors.initials: IR
authors.lastname: Byram
authors.forename: Carmen C
authors.initials: CC
authors.lastname: Wolfe
authors.forename: Kang-Hsien
authors.initials: KH
authors.lastname: Fan
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Koehler
authors.forename: John J
authors.initials: JJ
authors.lastname: Block
authors.forename: Martin I
authors.initials: MI
authors.lastname: Jordanov
authors.forename: Jeffry T
authors.initials: JT
authors.lastname: Watson
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Weikert
authors.forename: Donald H
authors.initials: DH
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000601:surgery; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging; D055815:Young Adult