Functional and radiological outcome of locking compression plate for distal end radius fracture

  • Patidar A
  • Jadhav A
  • Jain A
  • Bhinde S
  • Singh V
  • Rathore S S
  • Sharma S K
Keywords: distal end radius fracture, Volar plating, locking compression plate

Abstract

Background: Fracture distal end of radius are one of the most common skeletal injuries encountered in orthopaedic departments. Various modalities for treatment like close reduction and cast application, external fixators, ORIF with plate etc. Close reduction and cast application or K-wire fixation, external fixation is associated with immobilisation, wrist stiffness, loss of reduction postoperatively. So, we performed volar plating for distal end radius fractures and assessed the results.

Study design: Prospective case series of 48 patients who underwent volar plating for distal end radius fracture at CRGH associated with R D Gardi Medical College, Ujjain.

Methods: We performed ORIF with plating (Volar approach) in 48 patients (32 male and 16 female) of distal end radius fractures, depending on inclusion and exclusion criteria. Fractures were classified according to Frykman classification. All patients were operated under tourniquet and anaesthesia. Results were analysed using Green and o'brien scores for functional and Lidstrom classification for radiological outcome.

Results: Out of 48 patients, as per Frykman classification 1 had type III, 30 had type IV, 7 had type V,8 had type VI and 2 had type VII fractures. RTA as a (52.1%) mode of trauma was higher as compared to Fall (47.9%). Average time to clinico-radiological union was 8 weeks with the longest follow up time 6 months. Average time to wrist mobilisation was 8 days. According to Green and o'brien scores, 22 patients had excellent,20 good and 6 fair results. As per Lidstrom classification 26 patients had excellent,18 good and 4 fair results.

Conclusion: Volar plating for fracture distal end radius reduced the chances of wrist joint stiffness, loss of reduction and good results increased the patient compliance.

Downloads

Download data is not yet available.

References

1. Kapoor H, Agarwal A, Dhaon BK. Displaced intra-articular fractures of distal radius; a comparative evaluation of results following closed reduction, external fixation,and open reduction with internal fixation. Injury.2000;31(2):75-79.
2. Nana AD, Joshi A, Lichtman DM. Plating of the distal radius. J Am Acad Orthop Surg. 2005; 13(3): 159-171.
3. Kumar D, Breakwell L, Deshmukh SC, et al. Tangential views of the articular surface of the distal radius: Aid to open reduction and internal fixation of fractures. Injury. 2001; 32:783-786.
4. Koi K, Hattori Y, Otsuka K, et al. Intra-articular fractures of the distal aspect of the radius: Arthroscopically assisted Reduction Compared with Open Reduction and Internal Fixation. J Bone Joint Surg. 1999; 81:1093-110.
5. Konstantinidis L, Helwig P. Strohm PC et al. Clinical and radiological outcomes after stabilisation of complex intra-articular fractures of the distal radius with the volar 2.4 mm LCP. Arch Orthop Trauma Surg. 2009; 130(6):751-757.
6. Kwan K, Lau TW, Leung F. Operative treatment of distal radial fractures with locking plate system - a prospectively study. J. Hand Surg. Am. 2010; 21(1):31-39.
7. Smith DW, Henry MH. Volar Fixed-Angle Plating of the Distal Radius. J Am Acad Orthop Surg. 2005; 13(1):28-36.
8. Berglund LM, Messer TM. Complications of volar plate fixation for managing distal radius fractures. J Am Acad Orthop Surg. 2009; 17(6):369-377.
9. Jupiter JB, Marent-Huber M. Operative of distal radial fractures with 2.4-millimeter locking plates: A multicenter prospective case series. J Bone Joint Surg. Am. 2010; 92:96-106.
10. Pratap D, Deane AK, Peshin C. Radiological evaluation of distal radio-ulnar joint congruency in distal radius fractures. International Journal of Orthopaedics. 2018;4(1):787-91.
11. Agarwala S, Mohrir GS, Gadiya SD. Functional outcome in distal radius fractures treated with locking compression plate. Bombay Hospital J. 2012;54(2):209-19.
12. Van Eerten PV, Lindeboom R, Oosterkamp AE, Goslings JC. An X-ray template assessment for distal radial fractures. Arch Orthop Trauma Surg. 2008;128(2):217-21.
13. Osada D, Kamei S, Masuzaki K, Takai M, Kameda M, Tamai K. Prospective study of distal radius fractures treated with a volar locking plate system. J Hand Surg Am. 2008;33(5):691-700.
14. Gruber G, Zacherl M, Giessauf C, Glehr M, Fuerst F, Liebmann W. Quality of life after volar plate fixation of articular fractures of the distal part of the radius. J Bone Joint Surg Am. 2010;92(5):1170-8.
15. Lozano-Calderón S, Moore M, Liebman M, Jupiter JB. Distal radius osteotomy. In The elderly patient using angular stable implants and norian bone cement. J Hand Surg Am. 2007;32(7):976-83.
16. Chung KC, Watt AJ, Kotsis SV. Treatment of unstable distal radial fractures with the volar locking plating system. J Bone Joint Surg Am. 2006; 88:2687-94.
17. Arora R, Lutz M, Hennerbichler A, Krappinger D. Complications following internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma. 2007;21(5):316-22.
18. Kilic A, Kabukcuoglu Y, Ozkaya U, Gul M, Sokusu S, Ozdogan U.Volar locking plate fixation of unstable distal radius fractures. Acta Orthop Traumatol Turc. 2009;43(4):303-8
19. Minegishi H, Dohi O, An S, Sato H. Treatment of unstable distal radius fractures with volar locking plate. Ups J Med Sci. 2011;116(4):280-4.
20. Fok MWM, Klausmeyer MA, Fernandez DL, Orbay JL, Bergada AL. Volar plate fixation of intraarticular distal radius fractures: A retrospective Study J Wrist Surg. 2013;2(3):247-54.
21. Tank G, Gupta AK, Parvez A, Singh G, Jaiswal S, Kumar A. Anatomical and functional evaluation of distal end radius fractures managed by volar plating. Pros study J evol Med dental Sci. 2013;7(2):802.
22. Jakob M, Rikli DA, Regazzoni P. Fractures of distal radius treated by internal fixation and early fuction. J.Bone Joint Surg. 2000;82-B;340-4.
23. Aggarwal AK, Nagi ON. Open reduction and internal fixation of volar Bartons fractures: A prospective study J ortho sur. 2004;12(2):230-4.
24. Santiago A, Calderón L, Souer S, Mudgal C, Jupiter JB, Ring D. Wrist Mobilization Following Volar Plate Fixation of Fractures of the distal part of radius. J Bone Joint Surg Am. 2008; 90:1297-304.
25. Rikli DA, Regazzoni P. Fractures of the distal end of the radius treated by internal fixation and early function: A preliminary report of 20 cases. J Bone Joint Surg. 1996;78(4):588-92.
26. Leung F, Tu YF, Chew WY, Chow SP. Comparison of external and percutaneous pin fixation with plate fixation for intra-articular distal radial fractures: A randomized study. J. Bone Joint Surg Am. 2008;90A (1):16-22.
27. Rizzo M, Katt BA, Carothers JT. Comparison of locked volar plating versus pinning and external fixation in the treatment of unstable intraarticular distal radius fractures. HAND. 2008; 3:111-7
28. Mudgal CS, Jupiter JB. Plate fixation of osteoporotic fractures of the distal radius. J. Orthop Trauma. 2008;22(8): S106-15.
29. Sobky K, Baldini T, Thomas K, Bach J, Williams A, Wolf JM. Biomechanical comparison of different volar fracture fixation plates for distal radius fractures. Hand (N Y). 2008;3(2):96-101.
30. Anakwe R, Khan L, Cook R, McEachan J. Locked volar plating for complex distal radius fractures: Patient reported outcomes and satisfaction. J Orthop Surg Res. 2010; 5:51.
31. Krukhaug Y, Gjerdet NR, Lundberg OJ, Lilleng PK, Hove LM. Different osteosynthesis for Colles’ fracture: a mechanical study in 42 cadaver bones. Acta Orthop. 2009;80(2):239-44
32. Fernandez DL. Should anatomic reduction be pursued in distal radial fractures? J Hand Surg. 2000; 25:523-7
33. Baratz ME, Des Jardins JD, Anderson DD, Imbriglia JE. Displaced Intra-articular fractures of the distal radius: Effect of fracture displacement on contact stresses In a cadaver model. J Hand Surg Am. 1996; 21:183-8.
34. Osada D, Viegas SF, Shah MA, Morris RP, Patterson RM. Comparison of different distal radius dorsal and volar fracture fixation plates: A biomechanical study. J Hand Surg. 2003;28A:94– 104.
35. Leung F, Zhu L, Ho H, Lu WW, Chow SP. Palmar plate fixation of AO type C2 fracture of distal radius using a locking compression plate: A biomechanical study in a cadaveric model. J Hand Surg. 2003;28B:263-6.
36. Wong KK, Chan KW, Kwok TK, Mak KH. Volar fixation of dorsally displaced distal radial fracture using locking compression plate. J Orthop Surg. 2005; 13:153-7.
37. Phadnis J, Trompeter A, Gallagher K, Bradshaw L, Elliott DS, Newman K. Midterm fuctional outcome after the internal fixation of distal radius fractures journal of orthopaedic surgery and research. 2012; 7:4.
38. Kaempfe FA, Wheeler, Peimer CA, Hvisdak KS, Ceravolo J, Senall J. Severe fractures of the distal radius: Effect of amount and duration of external fixator distraction on outcome. J Hand Surg (Am). 1993;18-A:33-41.
39. Papadonikolakis A, Shen J, Garrett Jp, Davis Sm, Ruch Ds. The effect of inreasing distraction on digital motion after external fixation of the wrist. J Hand Surg (Am). 2005; 30:773-9
Published
2022-12-31
How to Cite
1.
Patidar A, Jadhav A, Jain A, Bhinde S, Singh V, Rathore S S, Sharma S K. Functional and radiological outcome of locking compression plate for distal end radius fracture. ojmpc [Internet]. 2022Dec.31 [cited 2024Mar.2];28(02):75-2. Available from: https://ojmpc.com/index.php/ojmpc/article/view/162
Section
Original Article

Most read articles by the same author(s)

1 2 > >>