Flexor tendon complications in comminuted distal radius fractures treated with anatomic volar rim locking plates.
OBJECTIVE
Anatomic volar rim locking plates are designed with the aim of treating intraarticular distal radius fractures. When used to treat comminuted distal radius fractures, these plates can damage the flexor tendons. In this study, we sought to determine the radiological and functional results and rate of complications of these plates.


METHODS
We retrospectively reviewed the records of 36 patients (28 males, 8 females; mean age: 46.4 years) with AO/OTA Type C2-C3 distal radius fractures treated with anatomic volar rim distal radius plates between January 2011 and December 2014. Radial length, radial inclination and palmar tilt were compared with the intact wrist. Results were evaluated with the Mayo wrist and Lidstrom scores. Complications were documented throughout the follow-up period of 23.8 (range: 12 to 48) months.


RESULTS
Postoperative measurements of the radial length, inclination and palmar tilt did not differ significantly. Mayo wrist and Lidstrom scores were good and excellent in 27 and 32 patients, respectively. Flexor tenosynovitis was symptomatic in 15 patients and asymptomatic (localized swelling only) in 21. Plates were removed from 15 patients due to symptomatic tenosynovitis and from six patients due to partial rupture of the flexor pollicis longus tendon. The flexor digitorum profundus tendon of the second finger was also partially ruptured in three patients.


CONCLUSIONS
Anatomic volar rim locking plates provide satisfying radiological and functional results in treating AO/OTA Type C2-C3 comminuted distal radius fractures. However, if these plates interfere with the union of the fracture, they should be removed to avoid potential tendon problems caused by their placement in the rim region.


METHODS
Level IV, Therapeutic study.
Department of Orthopaedics and Traumatology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey.
Adnan
A
Kara
Department of Orthopaedics and Traumatology, Zonguldak Ataturk State Hospital, Zonguldak, Turkey. Electronic address: drhalukcelik@gmail.com.
Haluk
H
Celik
Department of Orthopaedics and Traumatology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
Yunus
Y
Oc
Department of Orthopaedics and Traumatology, Acibadem Maslak Hospital, Istanbul, Turkey.
Metin
M
Uzun
Department of Orthopaedics and Traumatology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey.
Mehmet
M
Erdil
Department of Orthopaedics and Traumatology, Acibadem Maslak Hospital, Istanbul, Turkey.
Cihangir
C
Tetik
D000328:Adult; D000368:Aged; D001860:Bone Plates / Q000009:adverse effects*; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012421:Rupture / Q000453:epidemiology; D013717:Tenosynovitis / Q000453:epidemiology; D014955:Wrist Joint / Q000601:surgery; D055815:Young Adult
Distal radius fracture; Flexor tendon complications; Intraarticular fracture; Volar plating