Outcome of fracture distal radius treated with open reduction internal fixation with volar locking compression plate (A study of 50 cases)

Author(s): Dr. Umesh Nagrale, Dr. Sagar Kadam, Dr Ravi Bhanushali, Dr. Prasannaditya mujumdar, Dr. Avik Sarkar and Dr. Irphan Shaikh

Abstract: Introduction: Fractures of the distal radius constitute one of the most common skeletal injuries treated by Orthopaedic surgeons. These injuries account for one sixth of all fractures and represent 17% of all the fractures evaluated in emergency room. The use of strong implant in the form of Fixed Angle Volar Locking Compression Plate theoretically achieves, maintain the reduction and stability in displaced intra-articular & extra-articular distal radius fractures in both the economically productive young age group as well as in the osteoporotic elderly population with less bone stock.Hence, we have decided to study the results of management of distal radius fractures with the open reduction and internal fixation with Volar locking compression plates.
Aim: To study the results of operative management of distal radius fractures in terms of functional and radiological outcome, with open reduction and internal fixation with Volar locking compression plates.
Materials and Methods: This was a prospective study, where Fifty adult patients with distal radial fractures, treated with a volar locking compression plate using a Modified volar Henry approach(i.e flexor carpi radialis FCR approach), were included in this study. The fracture fragments were analyzed and involvement of radiocarpal and distal radioulnar joints were assessed and classified according to the Frykman’s and AO classification. First follow up of patients was done between tenth to fifteenth post-operative days Subsequent follow ups were done for three months at monthly interval.At each follow up clinical and radiological assessment was done using different parameters.Final assessment of the outcome was done after three months, by MAYO WRIST scoring system.
Results and Discussion: In our series, we had 90% excellent, 6% good, 2%, fair and 2% poor result. Patients, who obtained excellent results, had no residual deformities or pain. Range of motion was within the normal functional range. Two patients (4%) had arthritic changes but no other complications. They were operated within 6 days after injury. Radial length, volar tilt and articular step-off were within acceptable limits. They were co-operative to physiotherapy. The results obtained in our series are comparable to other studies undertaken similarly.
Conclusion: Use of locked compression plates in distal radius fractures provided good to excellent results with correction and maintenance of distal radius anatomy. By using these plates, joint motions and daily functioning were recovered in a shorter time.

DOI: https://doi.org/10.22271/ortho.2018.v4.i1o.143