Volar locking plate fixation of unstable distal radius fractures

Objectives: We evaluated radiographic and functional re¬sults of volar locking plate fixation of unstable distal radius fractures. Methods: The study included 27 patients (15 males, 12 fe¬males; mean age 45 years; range 18 to 77 years) who were treated with volar locking plate fixation for unstable distal ra¬dius fractures. Twenty-two patients (81.5%) had AO type C and five (18.5%) had type B fractures. Two patients (7.4%) had type I open fractures. Dorsal and volar angulation were pres¬ent in 21 (77.8%) and six (22.2%) fractures, respectively. Four patients (14.8%) also had elbow dislocation and/or fracture and nine patients (33.3%) had disruption of the distal radioul¬nar joint. Autologous iliac crest graft was used in 10 patients (37%). Postoperative assessments included range of movement and grip strength measurements, and radiographic parameters using the Stewart criteria. Functional results were assessed using the Q-DASH (Quick-Disabilities of the Arm, Shoulder and Hand) questionnaire and the Gartland-Werley scale. The mean follow-up was 18 months (range 12 to 34 months). Results: All fractures united without a problem within a mean of 6.5 weeks (range 6 to 8 weeks). The following pa¬rameters became equal to the unaffected side: ulnar variance (n=21, 77.8%), radial inclination angle (n=13, 48.2%), radial tilt angle (n=8, 29.6%), and radial height (n=11, 40.7%). The mean radiographic Stewart score was 0.5 (range 0 to 3). The mean grip strength of the operated side was 72.4% (18 kg) of the normal side. The mean Q-DASH and Gartland-Werley scores were 8.3 (range 0 to 70.5) and 4.7 (range 0 to 16), respectively. According to the Gartland-Werley scale, the results were excellent in 12 patients (44.4%), good in 12 pa¬tients, and moderate in three patients (11.1%). Three compli¬cations (11.1%) occurred, including loss of alignment in two patients, and screw-related discomfort in one patient. Conclusion: Volar locking plate fixation is an effective treatment in the anatomical and functional restoration of unstable distal radius fractures.