Abstract: Background: Methods for surgical fixation of intra-articular distal end radius fractures has been on an evolving course. One among the novel developments is the use of variable angle locking plate. Its multidirectional locking option facilitates fixation of even the most complex of the fractures, especially in osteoporotic bone.
Aim: To study the functional and radiological outcome of operative management of intra-articular fractures of distal end of radius with variable angle locking compression plates.
Material & Methods: 56 adult patients (36 males and 20 females) who had intra-articular distal radius fractures satisfying the study criteria & treated at Sunshine hospitals, Secunderabad, Telangana, India between October 2015 and September 2017 using variable angle locking compression plates were taken up for the study. The cases were followed up at 6 weeks, 3 months, 6months and 12 months postoperatively. During each visit, functional outcome was assessed using Demerit score system of Gartland and Werley. Radial height, radial angulation and palmar angulation were measured from the xray to assess the radiological outcomes.
Results: There were 2 type B1, 8 type B2, 16 type B3, 13 type C1, 12 type C2 and 5 type C3 as per the AO classification. Functional assessment showed 29(51.78%) excellent results, 21(37.5%) good results, 6(10.71%) fair results and no poor results There was no significant difference in the radiological parameters between different follow-ups as signified by p value >0.05 implying that there was no loss of fixation. One patient had flexor pollicis longus tendon rupture at 13 months postop & was managed by Plate removal + transfer of Flexor Digitorum Superficialis tendon. Two patients developed superficial wound infection which susbsided with oral antibiotics. One patient developed Reflex Sympathetic Dystrophy which was managed medically. One patient had Screw malpositioning but remained asymptomatic through out the follow up period.
Conclusion: Variable angle locking plate offers predictable and good outcome in intra-articular fractures of the distal end of the radius.
