title: Mechanical failure of the distal radius volar locking plate.
abstract: OBJECTIVE
  To review 9 cases of mechanical failure of the volar locking plate for distal radial fractures.
  
  
  METHODS
  Records of 374 consecutive patients who underwent volar locking plating for distal radial fractures were reviewed. Mechanical failures of the volar locking plate were defined as plate breakage or bending, screw breakage or loosening, or collapse of articular fragments resulting in intra-articular screw extrusion.
  
  
  RESULTS
  Nine mechanical failures occurred between 2 weeks and 3 months in 8 (2.4%) of the patients aged 25 to 82 (median, 74) years with AO fracture types of A3 (n=4), C1 (n=1), C2 (n=1), and C3 (n=3). Mechanical failures included screw pullout (n=5), locking plate bending (n=2), locking screws breakage (n=1), and loosening of locked variable angle screws (n=1). One patient underwent revision of fixation and 2 underwent implant removal. The remainder were treated conservatively. All patients were followed up for a minimum of 12 months; their mean flexion arc was 87 degrees (standard deviation [SD], 17) and the mean rotation arc was 136 degrees (SD, 29 degrees). According to the Green and O'Brien score, their outcomes were good (n=1), fair (n=4), and poor (n=3).
  
  
  CONCLUSIONS
  Although mechanical failure of volar locking plate is uncommon, some are potentially preventable.
authors.affiliation: Department of Hand and Reconstructive Microsurgery, National University Health System, Singapore.
authors.forename: Tun-Lin
authors.initials: TL
authors.lastname: Foo
authors.forename: Aaron W T
authors.initials: AW
authors.lastname: Gan
authors.forename: Tamara
authors.initials: T
authors.lastname: Soh
authors.forename: Winston Y C
authors.initials: WY
authors.lastname: Chew
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D053401:Palmar Plate / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging / Q000601:surgery*; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*
keywords: bone plates; radius fractures