Surgical Management of Unstable Distal Radius Fractures with a Variable-Angle Volar Locking Plate

Abstract

Background: The distal radius is one of the most commonly fractured bones in the body accounting for 8 - 15% of all broken bones. The use of variable-angle locking plates is promoted for the management of these fractures. This study aimed to evaluate the radiological and clinical outcome of the management of unstable distal radius fractures using a variable-angle volar locking plate.
Methods: This was performed a prospective cohort study on 18 patients with unstable distal end radius fractures, admitted to Orthopedic Department in Zagazig University Hospital and El-Menshawy General Hospital in Tanta. All patients were operated from January 2019 to June 2019. The affected patients’ age ranged from 24 to 65 years old with a mean of (37.06 ± 12.69). There were 12 males and 6 females. These fractures were treated by internal fixation (ORIF) using the variable angle 2.4-mm distal radius locking plate.
Results: There was one patient had a tourniquet palsy which was resolved after one month of physiotherapy (5.56%). One patient suffered from delayed wound healing (5.56%). One patient had screw misplacement in the radio-ulnar joint that remains asymptomatic at the final follow up period (5.56%). At the end of follow up period, inclination angle (frontal tilt) ranged from 17° to 24° (mean was 20.36° ± 2.53), volar (sagittal) tilt ranged from 7° to 14° (mean was 10.32° ± 2.26). According to the disabilities of arm, shoulder, and hand scoring system (DASH score), 8 patients (44.44%) had excellent results with an average 3.55 ± 1.24, 8 patients (44.44%) had good results with average 9.70 ± 1.98. There was a statistically highly significant correlation between the radiological outcome and final clinical score.
Conclusions: The use of variable-angle locking plates in treating unstable distal end radius fractures is associated with excellent to good functional outcomes with a significant reduction of hardware complication.