title: Volar plate fixation for the treatment of distal radius fractures: analysis of adverse events.
abstract: OBJECTIVE
  Determining the rate of specific adverse events after volar plating performed for distal radius fractures.
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  University level I trauma center.
  
  
  METHODS
  We searched the electronic database of all surgical procedures performed in our department using the following keywords: distal radius fracture, wrist fracture, and plate fixation. We identified 315 patients, 12 of whom were lost at follow-up.
  
  
  METHODS
  Volar plate fixation for the treatment of distal radius fractures.
  
  
  METHODS
  At an average follow-up of 5 years, 303 patients were evaluated through medical records and clinical and radiographic assessment for specific adverse events after volar plate fixation.
  
  
  RESULTS
  Adverse events were observed in 18 patients (5.9%). Implant-related adverse events, including tendon impairments, intra-articular screws, and screw loosening, were observed in 15 patients (5.0%). Extensor tendon impairments were represented by 5 cases of extensor tenosynovitis and 3 cases of rupture of the extensor pollicis longus due to screws protruding dorsally. Flexor impairments were represented by 2 cases of tenosynovitis and 2 cases of flexor pollicis longus rupture. Screw penetration into the radioulnar joint was observed in 1 case. Loss of reduction was identified in 3 cases. One patient had a deep postoperative infection treated with operative debridement. One patient experienced injury to the median nerve during routine implant removal unrelated to tendon issues.
  
  
  CONCLUSIONS
  The majority of adverse events after volar plate fixation were due to technical errors in implant placement. In our cohort, tendon impairments were the most frequently observed; among these, extensor tendon impairments were the most represented (50% of all adverse events). All 12 tendon-related adverse events were due to technical shortcomings with implant placement.
  
  
  METHODS
  Therapeutic level IV.
authors.affiliation: *Orthopaedics and Traumatology Department, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy; and †Hand and Microsurgery Department, Policlinico GB Rossi, Azienda Ospedaliera Universitaria Verona, Verona, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Tarallo
authors.forename: Raffaele
authors.initials: R
authors.lastname: Mugnai
authors.forename: Francesco
authors.initials: F
authors.lastname: Zambianchi
authors.forename: Roberto
authors.initials: R
authors.lastname: Adani
authors.forename: Fabio
authors.initials: F
authors.lastname: Catani
mesh_terms: D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates / Q000009:adverse effects* / Q000706:statistics & numerical data*; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000706:statistics & numerical data; D006225:Hand / Q000601:surgery; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D011885:Radius Fractures / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D014954:Wrist Injuries / Q000453:epidemiology / Q000601:surgery; D055815:Young Adult