title: Volar locking plate osteosynthesis for distal radial fractures.
abstract: OBJECTIVE
  To review the one-year outcome after volar locking plate fixation for distal radial fractures.
  
  
  METHODS
  Records of 22 men and 40 women aged 17 to 86 (mean, 52.5) years who underwent volar locking plate fixation for distal radial fractures were reviewed. According to the Fernandez classification, the distal radial fractures were classified as type 1 (n=20), type 2 (n=24), type 3 (n=6), type 4 (n=6), or type 5 (n=6). Three types of plate were used: Stryker Variax (n=33), Synthes LCP (n=20), and Smith & Nephew Peri-Loc (n=9). Wrist function was assessed at one year using the validated patient-rated wrist evaluation (PRWE) questionnaire.
  
  
  RESULTS
  14 (23%) of the 62 patients had 24 complications: stiffness (n=13), median nerve symptoms (n=4), malunion (n=2), implant removal for persistent pain and stiffness but no improvement shown (n=2), complex regional pain syndrome (n=2), and carpal arthritis (n=1). The complication rates for types 1, 2, 3, 4, and 5 fractures were 20%, 17%, 67%, 0%, and 33%, respectively (p=0.052). The complication rates for low-risk (types 1 and 2) and high-risk (types 3, 4, and 5) fractures were 18% and 33%, respectively (p=0.315). The complication rates for Stryker Variax, Synthes LCP, and Smith & Nephew Peri-Loc were 26%, 20%, and 14%, respectively (p=0.75). At one year, the mean PRWE score was comparable in patients with low-risk or high-risk fractures (14 vs. 19, p=0.5). 79%, 13%, and 8% of the patients recovered >50%, 20-50%, and <20% of range of movement of the contralateral side, respectively.
  
  
  CONCLUSIONS
  Volar locking plate fixation followed by early rehabilitation for distal radial fractures achieved good outcome, with a low rate of implant-related complications.
authors.affiliation: Countess of Chester Hospital NHS Foundation Trust, United Kingdom.
authors.forename: Saqib
authors.initials: S
authors.lastname: Javed
authors.forename: Rizwan
authors.initials: R
authors.lastname: Shahid
authors.forename: Ravi
authors.initials: R
authors.lastname: Thimmiah
authors.forename: Muj
authors.initials: M
authors.lastname: El-deen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D053401:Palmar Plate; D011885:Radius Fractures / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014955:Wrist Joint; D055815:Young Adult
keywords: radius fractures; treatment outcome; volar plate; wrist injuries