Abstract
BACKGROUND
In our institution we use the Winklestabile volar locking plate for operative fixation of distal radius fractures. This study aims to assess subjective and objective outcomes using this method of treatment.
METHODS
A total of 21 patients who underwent ORIF of distal radius fractures with the Winklestable plate in 2005 with a minimum follow up of 12 months were assessed using the Patient Rated Wrist Evaluation (PRWE) questionnaire and the Disabilities of the Arm Shoulder and Hand (DASH) score. Range of wrist movement (ROM), grip strength and pinchgrip strength were assessed by comparison with the unaffected wrist.
RESULTS
Mean age was 64.34yrs (median 65.74, interquartile range (IQR) 59.11 – 71.80). The mean time from presentation to surgery was 2.0 days (median 1.0, IQR 1.0 - 2.0). Radiological union was confirmed after a mean of 83.3 days (median 83.0, IQR 83.0 – 90.0). Twenty fractures followed low energy trauma and 19 were closed. Eleven fractures were extra-articular.
None, minimal or mild PRWE scores were achieved in 18 (86%) patients for pain, 15 (71%) for specific functions and 19 (90%) for usual functions. Six patients scored zero on the DASH score (mean 17.0, median 4.0, IQR 0.0-23.0). There was no difference in grip strength (pounds) in two patients (mean 10.6, median 6.0, IQR 4.0-15.0) and no difference in pinchgrip strength in nine patients (mean 1.0, median 0.5, IQR 0.0-1.5).
Sixteen patients (76%) reported no complications. Two patients required extra postoperative physiotherapy. One suffered extensor polis longus rupture. One reported generalised wrist pain. One reported difficulty pushing down with affected hand. One reported pain on movement. No patients required revision surgery.
CONCLUSION
In our institution, we believe that ORIF for distal radius fractures using the Winklestabile distal radius locking plate achieves satisfactory subjective and objective results with an acceptable rate of complications.
