PURPOSE: To prospectively determine the results of treatment of distal radius fractures with a volar locking plate system with no bone graft and early mobilization. METHODS: Internal fixation and early mobilization of dorsally displaced, unstable fractures of the distal radius using a volar locking plate system without bone grafting was investigated in a prospective series of 49 fractures in 49 consecutive patients. All patients were allowed to move the wrist joint immediately after surgery. Physical examination at 5 weeks, 3 months, 6 months, and 1 year after the operation were performed. Radiographic parameters on preoperative, postoperative, and 1-year postoperative radiographs were compared. At 1-year review, the final clinical functions were evaluated with the Gartland and Werley functional scoring system, a modified Green and O'Brien system, and the Disabilities of the Arm, Shoulder, and Hand questionnaire. RESULTS: The average radiographic results at 1 year were 9 degrees of volar tilt; 22 degrees of radial inclination; 1 mm of ulnar variance, and 0 mm of articular incongruity. At 1-year review, an excellent or good result was found according to the system of Gartland and Werley and a modified Green and O'Brien system with scores of 100% and 98%, respectively. The Disabilities of the Arm, Shoulder, and Hand score averaged 6, indicating a high degree of patient satisfaction. There were no cases of infection, complex regional pain syndrome, tendon rupture, tendon irritation, nerve injury, or implant failure. CONCLUSIONS: The volar locking plate fixation without bone grafting and early mobilization is a safe and effective treatment for dorsally displaced, unstable fractures of the distal radius.
PURPOSE: To prospectively determine the results of treatment of distal radius fractures with a volar locking plate system with no bone graft and early mobilization. METHODS: Internal fixation and early mobilization of dorsally displaced, unstable fractures of the distal radius using a volar locking plate system without bone grafting was investigated in a prospective series of 49 fractures in 49 consecutive patients. All patients were allowed to move the wrist joint immediately after surgery. Physical examination at 5 weeks, 3 months, 6 months, and 1 year after the operation were performed. Radiographic parameters on preoperative, postoperative, and 1-year postoperative radiographs were compared. At 1-year review, the final clinical functions were evaluated with the Gartland and Werley functional scoring system, a modified Green and O'Brien system, and the Disabilities of the Arm, Shoulder, and Hand questionnaire. RESULTS: The average radiographic results at 1 year were 9 degrees of volar tilt; 22 degrees of radial inclination; 1 mm of ulnar variance, and 0 mm of articular incongruity. At 1-year review, an excellent or good result was found according to the system of Gartland and Werley and a modified Green and O'Brien system with scores of 100% and 98%, respectively. The Disabilities of the Arm, Shoulder, and Hand score averaged 6, indicating a high degree of patient satisfaction. There were no cases of infection, complex regional pain syndrome, tendon rupture, tendon irritation, nerve injury, or implant failure. CONCLUSIONS: The volar locking plate fixation without bone grafting and early mobilization is a safe and effective treatment for dorsally displaced, unstable fractures of the distal radius.
Authors: Stefan Quadlbauer; Christoph Pezzei; Josef Jurkowitsch; Brigitta Kolmayr; Tina Keuchel; Daniel Simon; Thomas Hausner; Martin Leixnering Journal: J Wrist Surg Date: 2016-08-05