Therapeutic effects of volar anatomical plates versus locking plates for volar Barton's fractures

Volar Barton's fractures are uncommon and extremely unstable. Various surgical techniques have been reported in the literature, but open reduction and internal fixation using a volar plate system is currently advocated for the treatment of volar Barton's fractures. The purpose of this study was to compare the therapeutic effects of volar anatomical plates and volar locking plates in the treatment of volar Barton's fractures. A retrospective comparative study was performed of 33 patients with volar Barton's fractures treated between October 2005 and November 2010. One group was treated with a volar anatomical plate (n=16) and the other with volar locking plates (n=17). Radiological and functional results were compared between groups. All patients' fractures healed. Mean union time in the anatomical plate group was 12.93 weeks and in the locking plate group was 11.76 weeks (P>.05). No significant difference was noted between the 2 groups in terms of radial inclination, volar tilt, and ulnar variance. No significant differences were noted between the 2 groups in Disabilities of the Arm, Shoulder and Hand scores; however, according to Sarmiento's modification of the Gartland and Werley score, the excellent and good rate was 75% in the anatomic plate group and 94.1% in the locking plate group, which was statistically significant (P<.05). Anatomical and locking plates give satisfactory results in the treatment of volar Barton's fractures, but locking plates may provide better wrist function recovery.