Variable-Angle Locking Compression Plate Fixation of Distal Radius Volar Rim Fractures

To compare functional and radiographic outcomes of radius fractures distal to the watershed line treated with variable-angle volar rim locking compression plates (VA-LCP) with traditional fixed-angle volar rim locking compression plates (FA-LCP).

A retrospective review of patients who underwent open reduction and internal fixation (ORIF) using either VA-LCP (19 wrists) or traditional fixation with FA-LCP (28 wrists). The average follow-up period was 14.5 months (range 11-16 months) for the VA-LCP group and 15.8 months (range 12-18 months) for the FA-LCP group. Clinical outcomes were evaluated using the Modified Mayo wrist score (MMWS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, wrist range of motion (ROM) and grip strength relative to the uninjured side, and signs of flexor tendon irritation. Radiographic evaluation included radial height, radial inclination, volar tilt, and volar tear drop angle. All outcomes were assessed at 3, 6, and 12 months postoperatively.

MMWS and DASH scores improved with time postoperatively in both groups. Relative ROM was improved in VA-LCP compared to the FA-LCP at 12 months. VA-LCP was associated with a decreased incidence of flexor tendon irritation compared to FA-LCP. VA-LCP also better held the volar tilt reduction compared the FA-LCP.

VA-LCP shows improved clinical and radiographic outcomes throughout the follow up period when compared to traditional fixation. VA-LCP may be an effective alternative to traditional fixation methods to treat radius fractures distal to the watershed line.