Volar Locking Plate Breakage after Nonunion of a Distal Radius Osteotomy
Sergi Barrera-Ochoa1, Sergi Rodríguez-Alabau2, Andrea Sallent3
1Hospital Universitari Vall Hebron, Orthopedic Surgery Department, Hand and Microsurgery Unit, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Hospital Universitari Quiron-Dexeus, ICATME, Hand and Microsurgery Unit, C/Sabino de Arana 5-19, 08028 Barcelona, Spain; Vall Hebron Research Institute (VHIR), Musculoskeletal Tissue Engineering, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain.
Abstract:
We report a 38-year-old male with a nonunion followed by plate breakage after volar plating of a distal radius osteotomy. Volar locking plates have added a new approach to the treatment of distal radius malunions, due to a lower morbidity of the surgical approach and the strength of the final construction, allowing early mobilization and return to function. Conclusion. Plate breakage is an uncommon complication of volar locking plate fixation. To our knowledge, few cases have been described after a distal radius fracture and no case has been described after a distal radius corrective osteotomy. In the present case, plate breakage appears to have occurred as a result of a combination of multiple factors as the large corrective lengthening osteotomy, the use of demineralized bone matrix instead of bone graft, and the inappropriate fixation technique as an unfilled screw on the osteotomy site, rather than the choice of plate.
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