Open Reduction and Internal Fixation of Distal Radius Fractures with Complete Intra-articular Involvement and...

Area of Science:

• Orthopedic surgery
• Traumatology
• Biomedical engineering

Background:

• Distal radius fractures with intra-articular involvement and diaphyseal extension present fixation challenges.
• Current treatment options lack a universally superior method.
• Volar locking plates are commonly used worldwide for these fractures.

Purpose of the Study:

• To analyze outcomes of volar locking plate fixation for distal radius fractures.
• To evaluate the impact of fracture length on plate selection.
• To determine criteria for using extra-long distal radius plates.

Main Methods:

• Retrospective review of 89 patients with AO type C distal radius fractures and diaphyseal extension.
• Surgical treatment using volar locking plates with appropriate length selection.
• Radiographic and clinical outcome analysis, including union time and functional scores.

Main Results:

• C3 fractures were most common (50%), with average articular step-off of 1.7 mm and gap of 3.7 mm.
• Good radiographic alignment and functional scores (DASH 12.0, Mayo 83.6) were achieved.
• Extra-long plates (APTUS XL) were significantly longer than standard plates (62 mm vs. 35 mm, p < 0.001).

Conclusions:

• An extra-long distal radius plate is recommended for fractures exceeding 60 mm from the articular surface to the diaphysis.
• Appropriate volar plate length selection leads to favorable outcomes and low complication rates.
• Volar plate fixation provides stable fixation for complex distal radius fractures.