Volar Locking Plates in a Non-Academic Setting: Complications of Distal Radius Fracture Fixation in 300 Cases

The volar locking plate is an increasingly common method to treat distal radius fractures. This study aimed to assess whether complication rates following volar locking plate fixation for distal radius fractures for patients in a rural, non-academic setting are comparable to post-operative complication rates reported at larger academic centers.

A retrospective review of all patients who received volar locking plate fixation for distal radius fractures from January 2017 to February 2022 via the electronic medical record was performed at a single institution. A total of 300 patients were included in the study. Demographics, medical history, injury data, surgeon specialty and surgery data were collected along with any type of complications from surgery.

Overall, 79 complications were identified representing 26% of patients, with the most frequent being hardware removal due to discomfort (n=21, 7.0%) and stiffness (n=21, 7.0%), followed by median nerve neuropathy (n=15, 5.0%), and tendonitis/tenosynovitis (n=10, 3.3%). The mean age for all patients was 57 years, 81% of which were female. No significant difference was observed between complications and patient demographics, medical history, injury or surgery data. There was no significant difference in complications between hand fellowship trained surgeons (87% of cases, 23% complication rate) and non-hand orthopedic surgeons (13% of cases, 27% complication rate).

The complication rate following volar locking plate fixation for distal radius fractures in our rural, non-academic setting (26%) is comparable to post-operative complication rates reported at larger academic centers (11-30%).