Abstract
Historically the management of distal radial fracture has been often inadequate. It can be difficult to internally fix complex distal radial fractures with conventional plates. The fracture often collapses with metalwork failure. Literature suggests that malunion may lead to painful wrist with loss of function. In recent years fixed angle locking plate has been advocated for treatment of complex distal radius fracture. Our aim was to assess to assess the effectiveness of the volar locking plate (DePuy) in maintaining fracture reduction in distal radial fractures.
Radiographs of 170 distal radius fractures treated by the DVR plate were analysed. Fractures were classified according to the Melone and AO classifications. The post injury, intra-operative, 6 weeks postoperative and final postoperative radiographs were reviewed to obtain measurements for radial height, radial slope and volar inclination. The measurements were correlated with fracture pattern, locking screw length, presence or absence of radial styloid screw and plate placement in relation to the wrist joint. The results were analysed statistically using Wilcoxon signed rank test.
Radiologically there was minor loss of radial height, slope and volar inclination but this was not statistically significant. There was a statistically significant correlation between complexity of fracture and loss of radiological parameters. There was no statistically significant correlation between loss of radiological parameters and screw length, plate placement or presence or absence of radial styloid screw.
The DVR volar locking plate appears to maintain a satisfactory reduction of the fracture except for some complex fractures with dorsal comminution in which case dorsoradial plates may be preferable.
Correspondence should be addressed to Editorial Secretary Mr ML Costa or Assistant Editorial Secretary Mr B.J. Ollivere at BOA, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England; Email: mattcosta@hotmail.com or ben@ollivere.co.uk
