An Advanced Study on Volar Locking Plate as a Surgical Procedure for Distal Radius Fracture | Chapter 1 | New Frontiers in Medicine and Medical Research Vol. 7

The most common type of upper extremity fracture is DRF (distal radius fractures), which account for 44 percent of all forearm and hand fractures. The goal of surgical treatment for DRF that is unstable is to reestablish wrist function. Volar locking plates, according to some in the literature, are the most versatile surgical approach for treating these fractures. The goal of this study is to find out if the volar locking plate is the only surgical approach for treating all types of distal radius fractures while also lowering the rate of postoperative complications.

Materials and Methods: For unstable distal radius fractures, a volar locking plate was used to treat 104 fractures in 98 patients with an average age of 48,5 years. AO/OTA classified all fractures as A2-3 in 27 cases, B1-3 in 45 cases, and C1-3 in 32 occurrences. The majority of patients were operated on within 48 to 72 hours of their injuries. In all DRFs, a volar locking device was used, as well as an extended flexor carpi radialis approach. In sixteen cases with base of ulnar styloid fractures, low-profile locking plates were used, whereas Kirschner wires were used in the other patients. Following surgery, all patients had a standard rehabilitation programme that comprised passive and vigorous finger and wrist mobilisation.

Results: When evaluating patients, complications, time to fracture union, range of motion, Visual Analogue Scale, Quick Dash Score, and Patients-Rated Wrist Evaluation score were all considered. Patients with type A2-3 and B1-3 fractures under 60 years old exhibited a greater range of motion and grip strength than those over 65. In participants with type fractures C1-3 and an age of above 65, ROM and grip strength were reduced when compared to the unilateral side. In comparison to the other two types of fractures, type C1-3 appeared to have a higher percentage of complications and reoperation. Finally, type A, B, and C1 had higher Quick-DASH, PRWE, and range of motion rates than type C2-3.

In recent years, unstable fractures have necessitated surgery, with the volar locking plate acting as the gold standard. Unfortunately, VPL has postoperative issues with comminuted fractures or soft tissue injury that should not be neglected, and it may be insufficient for all types of distal radius fractures for these reasons.

Author (S) Details

G. Kastanis
Department of Orthopaedic, General Hospital of Heraklion –Venizeleio, Crete, Greece and Reconstructive Hand Surgery Unit, General Hospital of Heraklion –Venizeleio, Crete, Greece.

G. Magarakis
Department of Orthopaedic, General Hospital of Heraklion –Venizeleio, Crete, Greece.

P. Kapsetakis
Department of Orthopaedic, General Hospital of Heraklion –Venizeleio, Crete, Greece.

I. Stavrakakis
Department of Orthopaedic, General Hospital of Heraklion –Venizeleio, Crete, Greece.

A. Pantouvaki
Reconstructive Hand Surgery Unit, General Hospital of Heraklion –Venizeleio, Crete, Greece and Department of Physiotherapy, General Hospital of Heraklion –Venizeleio, Crete, Greece.

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