Prospective study of management of unstable distal radius fracture with volar plate osteosynthesis.”

Authors:Abhishek V. Shetty, Atmananda S. Hegdg, Deepak K. Raj, Mahesha K
Int J Biol Med Res. 2014; 5(3): 4300-4304  |  PDF File

Abstract

Introduction: - Fracture of the distal end radius constitutes one of the most common skeletal injuries treated by the orthopedic surgeon. Wide arrays of techniques have been described including closed reduction, percutaneous fixation and open methods of reduction and stabilization. Displaced extra- or intra-articular distal radius fractures require accurate reduction to allow a good outcome. We wished to assess the outcome of volar plate osteosynthesis to confirm satisfactory reduction and functional outcomes. Material and methods: - This is prospective study conducted in our medical institution between 2010 and 2012. . Inclusion criteria included skeletally mature patients who presented to casualty with unstable intra and extra-articular fractures of the distal radius. Open reduction and internal fixation with a volar plate under general anaesthesia was done in all patients. During the follow-up, radiological and functional parameters were assessed and Gartland and Werley scoring was done. Observation and results: In our study, a total number of 29 patients have been included who underwent volar plate fixation, out of which 4 patients were lost for complete follow up. Radiological parameters were well maintained and functional parameters showed significant improvement during the follow-up period. The mean Gartland and Werley score for 25 patients at the end of 24 weeks of follow-up was 3. Complication rate was 8% and they were promptly recognised and managed. Conclusion: - Primary volar plate fixation of unstable distal radius fracture provides a stable construct which helps in early mobilization, there by better functional outcomes and minimizes chances of delayed/malunion. However our study concludes that good intra-operative reduction and fixation is mandatory in order to reduce complications.