title: A new complication in volar locking plating of the distal radius: longitudinal fractures of the near cortex.
abstract: OBJECTIVE
  The purpose of this study was to document a new complication in volar locking plating of the distal radius.
  
  
  METHODS
  Between January 2007 and January 2014, 223 patients were identified from the department's surgical database with retrospective chart and radiographic review. Sixty-eight patients were over 60 years of age. All fractures were operated with Acu-Loc® (Acumed, Hillsboro, OR, USA) wrist volar locking plating systems. Longitudinal fracture lines (LFL) beneath volar plate-extending proximal shafts were documented. Correlations between age groups and LFLs were investigated. Radiographs with LFLs were assessed at final follow-up for the following parameters: volar tilt, radial inclination and radial length.
  
  
  RESULTS
  Twenty-eight of 68 patients over age of 60 years had LFLs. Correlation was significant for age groups (p<0.05). The effect of these fracture lines on radiographic parameters was not significant (p>0.05).
  
  
  CONCLUSIONS
  Surgeons should be aware of the complications that may occur with volar locking plates. Understanding of potential complications and their results are important. As a result of aging, thinning, and weakening, the near cortex may become more brittle. When the plate is reduced on the bone with a nonlocking screw, the conical head of diaphyseal locking screws can extend over plate thickness and penetrate the near cortex, acting as a screwing wedge. Additional divergent configuration may promote this effect and crack the cortex.
authors.affiliation: Hand Microsurgery Orthopaedics and Traumatology (EMOT) Hospital, İzmir, Turkey. tssugun@hotmail.com.
authors.forename: Tahir Sadık
authors.initials: TS
authors.lastname: Sügün
authors.affiliation: Hand Microsurgery Orthopaedics and Traumatology (EMOT) Hospital, İzmir, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Gürbüz
authors.affiliation: Hand Microsurgery Orthopaedics and Traumatology (EMOT) Hospital, İzmir, Turkey.
authors.forename: Kemal
authors.initials: K
authors.lastname: Özaksar
authors.affiliation: Hand Microsurgery Orthopaedics and Traumatology (EMOT) Hospital, İzmir, Turkey.
authors.forename: Tulgar
authors.initials: T
authors.lastname: Toros
authors.affiliation: Hand Microsurgery Orthopaedics and Traumatology (EMOT) Hospital, İzmir, Turkey.
authors.forename: Emin
authors.initials: E
authors.lastname: Bal
authors.affiliation: Hand Microsurgery Orthopaedics and Traumatology (EMOT) Hospital, İzmir, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Kayalar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates / Q000009:adverse effects*; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D053401:Palmar Plate / Q000601:surgery*; D011183:Postoperative Complications; D011859:Radiography; D011885:Radius Fractures / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D014421:Turkey; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult