HAVE THE NEWER GENERATION OF DISTAL RADIUS VOLAR LOCKING PLATES IMPROVED PATIENT OUTCOMES? A COMPARISON OF THE ORIGINAL SYNTHES VOLAR LOCKING PLATE WITH THE PERILOC PLATE

Abstract

Introduction: In recent years both patients and clinicians have benefitted from using volar locking plates (VLPs) to treat otherwise difficult to stabilise displaced distal radius fractures. However, it is not clear whether the newer VLP systems offer real clinical advantages over the original systems. AIM: To assess the clinical outcome of patients treated using two VLP systems.

Methods: Two cohorts of patients treated with a distal radius VLP were assessed prospectively by an independent assessor at 6 months following surgery using Visual Analogue Scales (pain & function), range of movement, grip and pinch strength. Complications were also recorded. 68 patients treated with the original Synthes VLP and 51 with a Periloc VLP (Smith & Nephew) were available for clinical review. There were no differences in patient demographics or injury types between the groups.

Results: Treatment with both VLP systems resulted in good or excellent clinical outcomes for both patient groups. Using either the median or the mean results, there were no differences between either of the VLP groups with respect to pain, subjective function, grip or pinch strength, palmar flexion, dorsiflexion, radial or ulnar deviation, or forearm rotation. The complication rates were also very similar, the most common problem relating to prominent metal work necessitating removal after fracture healing in 7 – 9% of out patients. Conclusion: VLPs are excellent implants for restoring wrist function and reducing longterm symptoms. The potential advantages of the newer generation of VLPs over the simpler original VLP designs remain unproven.