title: Unstable Distal Radius Fractures Treated by Volar Locking Anatomical Plates.
abstract: BACKGROUND
  Fracture of the distal end of radius represents the most common fracture of the upper extremity accounting for 16-20% of all fractures. Plating is now emerging as the gold standard for management of distal radius fractures due to increased rate of complications such as malunion, subluxation/dislocation of distal radio-ulnar joint or late collapse of fracture. Procedures such as closed reduction and cast immobilization, ligamentotaxis with external fixator and percutaneous pin fixation are no longer acceptable.
  
  
  OBJECTIVE
  The purpose of the study was to evaluate the functional and radiological outcome of unstable distal radius fractures treated with the volar locking plate.
  
  
  METHODS
  We reviewed 53 patients from January 2011 to December 2015, treated for unstable distal radius fractures using a volar locking compression plate. Standard radiographic and clinical assessment after 12 months (range 12-16 months) were measured and final functional and radiological outcome were assessed using the Modified Mayo wrist scoring system and Sarmiento's modification of Lindstorm criteria respectively.
  
  
  RESULTS
  There were 42 males and 11 females with an average age of 39.12±31.78 years (18-71 years). At the end of 12 months, 36 patients had an excellent radiological outcome and 10 patients had good radiological outcome as per Sarmiento's modification of Lindstorm criteria. Eleven patients had an excellent functional outcome and 26 patients had a good functional outcome as per modified Mayo wrist scoring system. There was one case of superficial wound infection which subsided with intravenous antibiotics.
  
  
  CONCLUSIONS
  The volar locking plate fixation helps in early mobilization of the wrist, restores anatomy, allows early return to function, prevents secondary loss of reduction and hence is an effective treatment for unstable fractures of the distal radius.
authors.affiliation: Resident, Department of Orthopaedics, Pondicherry Institute of Medical Sciences , Pondicherry, India .
authors.forename: Anto
authors.initials: A
authors.lastname: Jose
authors.affiliation: Associate Professor, Department of Orthopaedics, Pondicherry Institute of Medical Sciences , Pondicherry, India .
authors.forename: Shishir Murugharaj
authors.initials: SM
authors.lastname: Suranigi
authors.affiliation: Assistant Professor, Department of Orthopaedics, Pondicherry Institute of Medical Sciences , Pondicherry, India .
authors.forename: Pascal Noel
authors.initials: PN
authors.lastname: Deniese
authors.affiliation: Assistant Professor, Department of Orthopaedics, Pondicherry Institute of Medical Sciences , Pondicherry, India .
authors.forename: Abey Thomas
authors.initials: AT
authors.lastname: Babu
authors.affiliation: Professor, Department of Orthopaedics, Pondicherry Institute of Medical Sciences , Pondicherry, India .
authors.forename: Kanagasabai
authors.initials: K
authors.lastname: Rengasamy
authors.affiliation: Professor and Head, Department of Orthopaedics, Pondicherry Institute of Medical Sciences , Pondicherry, India .
authors.forename: Syed
authors.initials: S
authors.lastname: Najimudeen
keywords: Distal radio ulnar joint; Intra-articular fractures; LCP; Unstable fractures; Volar approach