O3041 THE AO DISTAL RADIUS PLATING SYSTEM: THE ADVANTAGES OF USING THE VOLAR APPROACH FOR MOST COMPLEX FRACTURES

Abstract

Aims: To assess the peroperative and postoperative ben-eþts of using the volar AO distal radius plate compared with the dorsal plate (Pi-plate) to treat complex intraar-ticular fractures involving the distal radius. Methods: One surgeonñs experience with the volar and dorsal plates is described in 25 patients (10 dorsal, 15 volar). 23 fractures were displaced dorsally, one fracture volar-wards, and one fracture had signiþcant volar and dorsal components. All of the fractures were classiþed as AO type C injuries. Patient ages ranged from 27 to 68 years (average 48). Active wrist mobilisation was commenced after 10–14 days. Range of motion and grip strength measurements were assessed by one hand physiotherapist, and the data reviewed retrospectively. Results: Operatively, the volar approach proved to be advantageous for the following reasons: anatomical landmarks were easier to identify, plate application was easier, intraoperative imaging was easier to interpret, bone graft was not required, and on average the operating time was reduced by 40%. Clinically, all of the fractures united and there were no infections or implant failures. More importantly, patients treated with the volar plate recovered good or excellent function (range of movement and grip strength) very much faster compared with those treated with the dorsal plate. Conclusions: The volar AO distal radius plate is an appropriate implant for the treatment of complex intraarticular fractures involving the distal radius, and can be used very effectively to treat dorsally displaced fractures. It also offers distinct peroperative and postoperative advantages compared with the dorsal plate.