Distal radius nonunion after volar locking plate fixation of a distal radius fracture: a case report

We describe a 59-year-old man who had nonunion of a right distal radius fracture after volar locking plate fixation. He underwent open reduction and internal fixation with a volar locking plate system for a dorsally displaced, unstable distal radius fracture at a previous hospital 5 months ago. Radiographs of the injured wrist showed nonunion of the distal radius with 1.5-mm ulnar minus variance. Radiographs of the unaffected wrist showed 3.5-mm ulnar plus variance. Intraoperative findings of surgical revision showed an unstable nonunion; thus, debridement of the nonunion, autogenous inlay bone grafting, and internal fixation using another type of volar locking plate system were performed. Healing of the re-operative site was confirmed radiographically 3 months postoperatively. We considered that volar locking plate fixation with excessive distraction of the fracture may lead to nonunion.