Results of volar locking plate osteosynthesis for distal radial fractures

To evaluate functional, radiologic, and subjective outcome after volar locking plate osteosynthesis (VLPO) for unstable distal radius fractures (DRF).

In this study, patients treated with VLPO for isolated DRF between March 2005 and December 2007 were prospectively evaluated. Patients with multiple injuries or those unavailable for follow-up were excluded from further evaluation. Range of motion, grip strength, and the subjective Patient-Rated Wrist Evaluation score were monitored for 6 weeks, 3 months, 6 months, and finally 1 year after surgery. The uninjured contralateral wrist served as control. The radiologic outcome after 1 year was scored using the Lidstrom score.

In total, 245 patients were included in the study with a mean age of 62 years ± 18 years. At the final follow-up, 1 year after surgery, 228 patients (93%) could be controlled. Range of motion significantly increased during follow-up. One year after surgery, mean flexion was 64° ± 15°, and mean extension reached 64 ° ± 15 ° corresponding with >90% of the uninjured contralateral wrist function. Grip strength increased from 14 kg ± 8 kg (54%) 6 weeks after surgery to 25 kg ± 11 kg (91%) at the final follow-up. Patient-Rated Wrist Evaluation score resulted in mean 8 points ± 16 points after 1 year. Lidstrom score reached a mean of 1.3 points ± 0.6 points, demonstrating a good initial fracture reduction and stable fixation. A complication rate of 15% could be seen in our series, among secondary fracture displacement in two patients (1%).

VLPO for the treatment of unstable DRF is a reliable technique with excellent subjective, objective, and radiologic outcome.