title: Radiographic alignment of unstable distal radius fractures fixed with 1 or 2 rows of screws in volar locking plates.
abstract: OBJECTIVE
  We tested the null hypothesis that there is no difference in the change in volar tilt of the articular surface of the distal radius on lateral radiographs obtained before suture removal and 3 months or more after surgical fracture fixation when 1 or 2 rows of screws are used in the distal part of a volar locked plate.
  
  
  METHODS
  We retrospectively identified 364 consecutive patients with a distal radius fracture treated by 2 surgeons with open reduction and volar locked plate fixation between 2007 and 2011 at our institution. A manually case-matched design with one-to-one matching of 2 different strategies for screws in the distal part of the plate (1 row versus 2 rows) on the basis of sex, AO type, presence of dorsal comminution, ulna fracture, mechanism of injury, and age (± 8 y) resulted in a group of 34 pairs, 68 total fractures. Radiographic alignment was measured before suture removal and 3 months or more after surgery.
  
  
  RESULTS
  The change in volar tilt of the articular surface was -1.2° in the 1-row group and -0.9° in the 2-row group, which was not significantly different. The secondary displacement of radial inclination and ulnar variance were likewise small and not statistically significant.
  
  
  CONCLUSIONS
  We found no advantage of 2 rows of distal screws over a single row of screws with respect to maintenance of achieved restoration of volar angulation after volar locked plate fixation of AO type A and C fractures of the distal radius.
  
  
  METHODS
  Therapeutic III.
authors.affiliation: Orthopaedic Hand Service, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Valentin
authors.initials: V
authors.lastname: Neuhaus
authors.forename: Omar
authors.initials: O
authors.lastname: Badri
authors.forename: Steven
authors.initials: S
authors.lastname: Ferree
authors.forename: Arjan G J
authors.initials: AG
authors.lastname: Bot
authors.forename: David C
authors.initials: DC
authors.lastname: Ring
authors.forename: Chaitanya S
authors.initials: CS
authors.lastname: Mudgal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001863:Bone Screws; D004867:Equipment Design; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D017759:Fractures, Malunited / Q000000981:diagnostic imaging / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000517:prevention & control; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D014954:Wrist Injuries / Q000000981:diagnostic imaging* / Q000601:surgery*; D055815:Young Adult