Distal volar radial plates: how anatomical are they?

Area of Science:

• Orthopedic surgery
• Radiology
• Anatomy

Background:

• Distal radius fractures are common injuries.
• Volar locking plates are increasingly used for treatment, aiming for anatomical fixation.
• Current plates have a standard volar cortical angle (VCA) of 25 degrees.

Purpose of the Study:

• To compare the actual volar cortical angle (VCA) of uninjured distal radii with the angulation of current volar locking plate designs.
• To assess the anatomical accuracy of existing implants for distal radius fracture treatment.

Main Methods:

• Retrospective analysis of 100 distal radius Computed Tomography (CT) scans.
• Measurement of the volar cortical angle (VCA) in the sagittal plane for each radius.
• Statistical comparison of measured VCA with standard plate designs.

Main Results:

• The mean VCA in the analyzed distal radii was 32.9 degrees, significantly higher than the 25-degree VCA of current plates.
• A significant difference in VCA was observed between male (33.6 degrees) and female (31.5 degrees) patients.
• Lateral and medial VCAs also showed significant differences (32.2 vs 34.3 degrees).

Conclusions:

• The anatomical volar cortical angle of the distal radius exceeds the angulation of contemporary volar locking plates.
• Current plate designs may not allow for precise anatomical reconstruction of the distal radius during fracture fixation.
• This discrepancy highlights a potential limitation in achieving optimal outcomes with existing implant technology for distal radius fractures.