Clinical and Radiographic Outcomes Following Volar-Locked Plating Versus Dorsal Bridge Plating for Distal Radius...

Area of Science:

• Orthopedic Surgery
• Trauma Care
• Biomechanical Engineering

Background:

• Distal radius fractures (DRFs) are common injuries requiring operative intervention.
• Volar-locked plating (VLP) is the predominant surgical technique for DRFs.
• Dorsal bridge plating (DBP) serves as an alternative fixation method for DRFs.

Purpose of the Study:

• To compare radiographic and clinical outcomes of VLP versus DBP for DRFs.
• To utilize propensity score matching for a robust comparative analysis.
• To evaluate functional recovery and complication rates between VLP and DBP.

Main Methods:

• Retrospective analysis of 2015-2022 data from a level-1 trauma center.
• Propensity score matching based on demographic, comorbidity, fracture classification, and PROMIS scores.
• Assessment of postoperative complications, range of motion (ROM), grip strength, and radiographic parameters.

Main Results:

• VLP demonstrated significantly improved grip strength and ROM at 6 months compared to DBP.
• DBP group had higher rates of malunion and nonunion compared to VLP.
• VLP showed superior outcomes in radial height, radial inclination, and articular step-off; volar tilt was comparable.
• PROMIS scores for upper extremity and physical function were higher in the VLP group.

Conclusions:

• Volar-locked plating (VLP) is associated with superior clinical and radiographic outcomes for distal radius fractures compared to dorsal bridge plating (DBP).
• While statistically significant, the clinical relevance of observed improvements in ROM and radiographic parameters warrants further clinical consideration.
• DBP is associated with higher rates of malunion and nonunion, suggesting VLP may offer better fracture healing and stability.