[Locked volar plating for complex distal radius fractures: maintaining radial length]

Area of Science:

• Orthopedic Surgery
• Traumatology
• Biomechanics

Background:

• Maintaining radial length is crucial for functional recovery after distal radius fractures.
• Bridging external fixation is a traditional method but may have drawbacks like algodystrophy.
• Fixed-angle volar plating offers joint-sparing fixation.

Purpose of the Study:

• To evaluate the efficacy of fixed-angle volar plating in maintaining radial length in complex distal radius fractures.
• To assess the incidence of secondary displacement and malunion.
• To identify risk factors for complications such as algodystrophy.

Main Methods:

• Prospective study of 43 patients with distal radius fractures and positive ulnar variance.
• Treatment involved open reduction and fixed-angle volar plating.
• Radial length and angulation were monitored postoperatively for six months.

Main Results:

• Correction of ulnar variance was maintained, irrespective of comminution or initial reduction.
• Only 3 patients lost >1 mm of radial length; 13 had incomplete reduction of posterior tilt.
• Secondary displacements were linked to locking technique errors; 8 patients developed algodystrophy.

Conclusions:

• Fixed-angle volar plating is effective in maintaining radial length if locking technique is correct.
• Accurate reduction of displaced articular fractures remains the primary challenge.
• The study could not definitively conclude superiority over external fixation.