Results of volar locking plate osteosynthesis for distal radial fractures

Abstract

Background: To evaluate functional, radiologic, and subjective outcome after volar locking plate osteosynthesis (VLPO) for unstable distal radius fractures (DRF).

Methods: In this study, patients treated with VLPO for isolated DRF between March 2005 and December 2007 were prospectively evaluated. Patients with multiple injuries or those unavailable for follow-up were excluded from further evaluation. Range of motion, grip strength, and the subjective Patient-Rated Wrist Evaluation score were monitored for 6 weeks, 3 months, 6 months, and finally 1 year after surgery. The uninjured contralateral wrist served as control. The radiologic outcome after 1 year was scored using the Lidstrom score.

Results: In total, 245 patients were included in the study with a mean age of 62 years ± 18 years. At the final follow-up, 1 year after surgery, 228 patients (93%) could be controlled. Range of motion significantly increased during follow-up. One year after surgery, mean flexion was 64° ± 15°, and mean extension reached 64 ° ± 15 ° corresponding with >90% of the uninjured contralateral wrist function. Grip strength increased from 14 kg ± 8 kg (54%) 6 weeks after surgery to 25 kg ± 11 kg (91%) at the final follow-up. Patient-Rated Wrist Evaluation score resulted in mean 8 points ± 16 points after 1 year. Lidstrom score reached a mean of 1.3 points ± 0.6 points, demonstrating a good initial fracture reduction and stable fixation. A complication rate of 15% could be seen in our series, among secondary fracture displacement in two patients (1%).

Conclusions: VLPO for the treatment of unstable DRF is a reliable technique with excellent subjective, objective, and radiologic outcome.