Volar Plating Versus Combined Plating For AO Type C Distal Radius Fracture: A Randomized Controlled Study Of 135...

Area of Science:

• Orthopedic surgery
• Traumatology
• Hand and wrist surgery

Background:

• Distal radius fractures (DRFs) are common, with AO type C fractures often requiring surgical intervention.
• Treatment options include volar plating and combined plating, with varying clinical outcomes.

Purpose of the Study:

• To compare clinical and radiographic outcomes 5 years post-surgery for AO type C DRF treated with volar plating versus combined plating.

Main Methods:

• 150 patients with AO type C DRF were randomized to volar locking plate or combined plating.
• A 5-year follow-up included radiographic assessment, pain evaluation, grip strength, range of motion, and patient-reported outcome questionnaires.
• Arthritis was graded using the Knirk and Jupiter classification.

Main Results:

• 90% follow-up rate (135 patients). No difference in radiographic arthritis.
• Volar plate group showed significantly better flexion, extension, radial deviation, and Patient-Rated Wrist Evaluation scores (P < .05).
• Hardware removal was significantly lower in the volar plate group (30% vs. 64%, P < .001).

Conclusions:

• Volar plating demonstrates superior clinical outcomes at 5 years for AO type C DRF compared to combined plating.
• Despite not reaching minimal clinically important difference, volar plating is supported as the preferred surgical method.
• Reduced need for hardware removal further supports volar plating for AO type C DRFs.