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Plate fixation of distal radius fracture and related complications
Laurent Obert1, Francois Loisel, Sonia Huard
1Service de Chirurgie Orthopédique, Traumatologique, Plastique et Reconstructrice, Assistance main, CHU J. Minjoz, 3 Bd A. Fleming, 25000, Besançon, France.
Introduction:
Distal radius fractures are common. In cases where surgical treatment is needed, volar plates can be used to obtain stable, long-lasting fixation. The design of these plates has continually improved over the years, but complications remain a problem.
Purpose:
The goal of this study was to evaluate the types of complications that occur with different types of volar plates with a view towards preventing them.
Materials And Methods:
The emergency department at our hospital saw 524 patients with distal radius fractures between 2006 and 2008. Some of these were treated surgically with a volar plate. All of the post-operative complications were documented.
Results:
With a minimum follow-up of 6 months, 152 patients who had undergone plate fixation were reviewed: 31 had received plates with non-locking screws or uniaxial locking screws and 121 had received plates with polyaxial locking screws. The complication rate was similar in these two groups (16.1 and 16.5%, respectively). The main complications were tendon ruptures and problems related to the plate itself.
Discussion:
Plate-related complications have been described in published studies, but few of these studies link them to the plate design or surgical technique. Manufacturers must continue to refine these plates to minimise their thickness while keeping their strength. Surgeons must be sure to use a highly exacting technique.
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