Evaluation of radiographic fracture position 1 year after variable angle locking volar distal radius plating: a prospective multicentre case series.
Treatment with a variable angle locking plate can, in theory, maintain near anatomic reduction of intra-articular distal radius fractures, but it is unknown to what extent reduction is maintained as measured by computed tomography. We assessed changes in radiographic fracture position 1 year post-operatively. We included 73 patients of whom 66 patients (90%) had radiographs available for review at 1 year post-operatively. We found a small (less than 2 mm or 2°) but statistically significant change in several measures. Accounting for inter-observer variability, this is probably within measurement error. We found no difference in change in fracture position or range of motion, grip strength or patient-reported outcome between the use of one or two distal rows of screws. Our results show that minimal changes in reduction can be expected after volar plate fixation in most patients. We recommend using only one screw row routinely, limiting costs, surgical time and the risk of misplacement of screws.


METHODS
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1 Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital - Harvard Medical School, MA, USA.
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Teunis
1 Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital - Harvard Medical School, MA, USA.
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Jupiter
2 Zentrum für Muskoskeletale Chirurgie, Charité-Universitätsmedizin Berlin, Berlin, Germany.
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Schaser
3 Unfallkrankenhaus Graz, Graz, Austria.
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Fronhöfer
4 Chirurgie und Traumatologie, Kantonsspital Luzern, Luzern, Switzerland.
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Babst
5 Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster, Germany.
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Langer
6 Klinik für Allgemein-, Hand- und Unfallchirurgie, Stadtspital Triemli, Zurich, Switzerland.
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Platz
7 Spital Zollikerberg, Zollikerberg, Switzerland.
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Schierz
8 AO Clinical Investigation and Documentation (AOCID), Dübendorf, Switzerland.
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Joeris
9 Traumatologie und Unfallchirurgie, Universitätsspital Basel, Basel, Switzerland.
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Rikli
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal; D018737:Hand Strength; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D011446:Prospective Studies; D011885:Radius Fractures / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed
Distal radius; alignment; fractures; volar locking plate