Journal of Musculoskeletal Trauma

Primary Open Reduction and Plate Fixation in Open Comminuted Intra-Articular Distal Radius Fracture: Jun-Ku Lee, Soonchul Lee, Weon Min Cho, Minkyu Kil, Soo-Hong Han; J Korean Fract Soc 2021;34(1):16-22. Published online January 31, 2021; DOI: https://doi.org/10.12671/jkfs.2021.34.1.16

Abstract PDF: Purpose
There are no standard surgical treatments for open distal radius fractures (DRFs), and the fracture fixator is chosen by the surgeon’s own experience. This study compared the outcomes of open reduction and volar locking plating (OR VLP) between closed and open AO-OTA type C3 DRFs. Materials and Methods: Patient data were retrospectively collected between January 2010 and December 2018. Only patients aged >18 years with AO-OTA C3 DRFs were included. After further exclusion, the patients with DRFs were divided into two groups: 13 patients with open DRFs in Group 1 and 203 patients with closed DRFs in Group 2. Data on the patient characteristics and treatment-related factors were further investigated. For the radiological evaluation, the radial height, volar height, and volar titling were measured based on the final plain radiography, and the union time was measured. The wrist range of motion (ROM), pain visual analogue scale score, and modified Mayo wrist score for function were measured at the final outpatient follow-up. Finally, the complications associated with OR VLP fixa-tion were investigated. Results: In the demographic comparison, the patients with open fractures were older (mean age, 62years) than those with closed fractures (mean age, 57 years), without a statistically significant differ-ence. The patients with open DRFs had longer antibiotic therapy and hospital stay durations. Although they presented a higher radial inclination, with statistical significance, the clinical implication was low with a mean difference of 3°. No significant differences were observed for the remaining radiological parameters, wrist ROM, and functional scores. An open DRF did not increase the complication rates,including deep infection. Conclusion: Depending on the expertise of the operating surgeon, the primary OR VLP fixation in open intra-articular comminuted DRF did not increase the incidence of deep infections and yielded similar outcomes to a closed intra-articular comminuted DRF.

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Treatment of the Communited Distal Radius Fracture Using Volar Locking Plate Fixation with Allogenic Cancellous Bone Graft in the Elderly: Je Kang Hong, Chang Hyun Shin; J Korean Fract Soc 2015;28(1):8-16. Published online January 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.1.8

Abstract PDF: PURPOSE
We studied results of the communited distal radius fracture treated with allogenic cancellous bone graft and volar locking plate in the elderly.
MATERIALS AND METHODS
We studied 29 cases of communited distal radius fracture treated with allogenic cancellous bone graft and volar locking plate from April 2009 to April 2013. Fracture was classified according to AO/OTA classification. Postoperative clinical evaluation was performed with measurement of wrist range of motion (ROM) at last follow-up, modified Mayo wrist scoring system (MMWS), and visual analogue pain scale (VAS). Radiologic evaluation was performed with measurement of radial length on immediate postoperation and last follow-up, radial inclination, volar tilt and ulnar variance checked at the last follow-up using Sarmiento criteria.
RESULTS
Using the MMWS, 13 cases were classified as 'good', 10 'fair', and 5 'normal'. The average wrist ROM was 88.5% for flexion, 92.2% for extension, 90.5% for adduction, and 94.0% for abduction. The average VAS was 1.7. On the last follow-up, average radius length, radial inclination and volar tilt did not show statistically significant improvement (p>0.05) compared to immediate post operation measurements, and according to Sarmiento criteria, 5 cases were classified as 'good', 14 'fair', and 7 'normal'.
CONCLUSION
Treatment of severe communited distal radius fracture accompanied by bone defect with volar locking plate and allogenic cancellous bone graft is a satisfying and effective treatment method in the elderly.

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Treatment of Fractures of the Distal Radius Using Variable-Angle Volar Locking Plate: Jae Cheon Sim, Sung Sik Ha, Ki Do Hong, Tae Ho Kim, Min Chul Sung; J Korean Fract Soc 2015;28(1):46-52. Published online January 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.1.46

Abstract PDF: PURPOSE
The purpose of this study is to evaluate outcome of variable-angle volar locking plate for treatment of distal radius fractures.
MATERIALS AND METHODS
We retrospectively analyzed the results in 45 cases treated by variable-angle volar locking plate. We evaluated the clinical results according to the Mayo wrist performance scoring system and radiographic results.
RESULTS
All cases had bony union. The mean Mayo wrist performance scoring system was 84.8. Between preoperative and immediate postoperative radiographic measurement, the mean radial length improved from 8.4 to 11.8 mm, radial inclination from 14.2degrees to 22.4degrees, volar tilt from -4.5degrees to 9.6degrees, and intraarticular step-off from 1.8 to 0.3 mm (p<0.05). Between immediate postoperative and latest follow-up radiographic measurements, the mean loss of radial length measured 0.8 mm, radial inclination 0.4degrees, and volar tilt 0.9degrees (p>0.05). All cases showed bone union with no evidence of malunion, nonunion, or metal failure.
CONCLUSION
Treatment of distal radius fractures using variable angle volar locking plate showed satisfactory outcomes. It is a good option to obtain stable fixation without significant loss of reduction.

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The Fate of Pronator Quadratus Muscle after Volar Locking Plating of Unstable Distal Radius Fractures: Chae Hyun Lim, Heun Guyn Jung, Ju Yeong Heo, Young Jae Jang, Yong Soo Choi; J Korean Fract Soc 2014;27(3):191-197. Published online July 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.3.191

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the pronator quadrates muscle in patients who underwent internal fixation with a volar locking plate for unstable distal radius fractures.
MATERIALS AND METHODS
Forty patients who underwent internal fixation with a volar locking plate for unstable distal radius fracture were enrolled. We evaluated the clinical results according to the Mayo wrist score, the wrist range of motion, and the grip strength at the last follow-up. Using ultrasonography, muscle thickness of the pronator quadrates was compared between injured and uninjured arm.
RESULTS
Bone union was achieved in all cases. The mean Mayo wrist score was 82.79 points. The grip strength of the injured arm was decreased to 89.1% of the uninjured side. The decrease of pronation range of the injured wrist motions was significant (82.3degrees, p=0.004). There was significant atrophy of the pronator quadrates muscle on the injured side (injured side: 3.19 mm, uninjured side: 4.72 mm, p=0.001); and the decrement of muscle thickness in pronator quadrates showed an association with the Mayo wrist score (r=-0.35, p=0.042).
CONCLUSION
These results suggest that continuity of the muscle is maintained after use of the volar locking plating for unstable distal radius fractures with repair of pronator quadrates; however, there is atrophy of pronator quadrates muscle and limitation of pronation in the injured wrist.

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Clinical Assessment after the Volar Locking Plate Removal of Distal Radius Fracture: Hee Chul Gwak, Joo Yong Kim, Gyu Min Kong, Jung Won Kim, Jae Yong Kwak, Dong Gyun Kim; J Korean Fract Soc 2014;27(1):23-28. Published online January 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.1.23

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the clinical outcomes after removing the volar locking plate for distal radius fracture.
MATERIALS AND METHODS
We reviewed retrospectively the medical records of 34 patients, 36 cases after removing the plates among 150 patients, with 162 cases that underwent open reduction and internal fixation using the volar locking plate between January 2006 and May 2011. We performed preoperative and postoperative clinical assessments using the quick-disabilities of the arm, shoulder and hand (Q-DASH), the visual analog scale (VAS) score, and the range of motion on wrist, grip and pinch power.
RESULTS
The major reason for plate removal was the time to remove the plate according to the fracture union and the patient's demand without other specific complaints (28 cases). The mean preoperative VAS score was 1.78 and the mean postoperative VAS score 1.81 (p=0.64). The mean preoperative Q-DASH score was 30.02 and the mean postoperative Q-DASH score 38.46 (p<0.001). The mean preoperative grip and pinch power were 18.14 kg and 7.67 kg. The mean postoperative grip and pinch power were 15.27 kg and 6.94 kg (p=0.23).
CONCLUSION
The removal of the volar locking plate for distal radius fracture should be decided by considering the patient's clinical and socioeconomic conditions carefully.

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Comparative Analysis of the Results of Fixed-angle versus Variable-angle Volar Locking Plate for Distal Radius Fracture Fixation: Seung Do Cha, Jai Hyung Park, Hyung Soo Kim, Soo Tae Chung, Jeong Hyun Yoo, Joo Hak Kim, Jung Hwan Park; J Korean Fract Soc 2012;25(3):197-202. Published online July 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.3.197

Abstract PDF

PURPOSE
To compare the outcomes of distal radius fractures in a fixed-angle volar locking plate group and variable-angle volar locking plate group.
MATERIALS AND METHODS
Forty-one patients observed at least 6 months after surgery were included in this retrospective study. We used the range of motion, visual analogue scale score, Disabilities of the Arm, Shoulder and Hand Questionnaire score, and radiologic findings to measure the clinical results.
RESULTS
No differences in clinical results or radiologic results were noted between the fixed-angle volar locking plate group and variable-angle volar locking plate group.
CONCLUSION
We believe that it is important to minimize complications by using appropriate screws and plates according to the fracture type, though no differences in the surgical outcome were noted between the fixed-angle volar locking plate group and variable-angle volar locking plate group with distal radius fracture.

Citations

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Volar locking plate fixation for distal radius fractures: did variable-angle plates make difference?
Mohamed Abdel-Wahed, Ahmed Abdel-Zaher Khater, Mahmoud Ahmed El-Desouky
International Orthopaedics.2022; 46(9): 2165. CrossRef
Treatment of Fractures of the Distal Radius Using Variable-Angle Volar Locking Plate
Jae-Cheon Sim, Sung-Sik Ha, Ki-Do Hong, Tae-Ho Kim, Min-Chul Sung
Journal of the Korean Fracture Society.2015; 28(1): 46. CrossRef
Functional Outcomes of Percutaneous K-Wire Fixation for Distal Radius Fractures with or without Osteoporosis
Ki-Chan An, Gyu-Min Kong, Jang-Seok Choi, Hi-Chul Gwak, Joo-Yong Kim, Sung-Yub Jin
Journal of the Korean Fracture Society.2013; 26(4): 248. CrossRef

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Volar Plating of Distal Radius Fractures: Kwang Hyun Lee; J Korean Fract Soc 2008;21(4):325-333. Published online October 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.4.325

Abstract PDF

Volar plating seems to indicate that many surgeons believe it leads to superior results, and is attractive because of the ease of the operative approach and the soft tissue sleeve to protect digital and wrist tendons. And also it have a locking mechanism to produce the fixed angle device with a low profile and may be thought to be a new era in the surgical treatment of dorsally displaced distal radius fractures even in the face of comminuted or osteoporotic bone. Locked volar plating allows direct fracture reduction, stable fixation and provides stability enough to allow early mobilization and function. The results with volar locking or fixed angle fixation for the general treatment of unstable distal radius fractures in elderly patients has been favorable. Volar plating has fewer complications than external fixation and dorsal plating and allow for earlier return to function. The current indications, technical aspects, clinical results, and complications of the volar plating are being reviewed.

Citations

Citations to this article as recorded by

Ultrasonographic Assessment of the Pronator Quadratus Muscle after Surgical Treatment for Distal Radius Fractures
Dong Hyuk Choi, Hyun Kyun Chung, Ji Won Lee, Cheol Hwan Kim, Yong Soo Choi
Journal of the Korean Fracture Society.2017; 30(2): 69. CrossRef
The Fate of Pronator Quadratus Muscle after Volar Locking Plating of Unstable Distal Radius Fractures
Chae-Hyun Lim, Heun-Guyn Jung, Ju-Yeong Heo, Young-Jae Jang, Yong-Soo Choi
Journal of the Korean Fracture Society.2014; 27(3): 191. CrossRef
Comparison of Operative Management in Distal Radius Fractures Using 3.5 mm Versus 2.4 mm Volar Locking Compression Plates
Sung-Sik Ha, Tae-Ho Kim, Ki-Do Hong, Jae-Chun Sim, Jong Hyun Kim
Journal of the Korean Fracture Society.2011; 24(2): 156. CrossRef
Treatment for Unstable Distal Radius Fracture with Osteoporosis -Internal Fixation versus External Fixation-
Jin Rok Oh, Tae Yean Cho, Sung Min Kwan
Journal of the Korean Fracture Society.2010; 23(1): 76. CrossRef
Short Term Results of Operative Management with 2.4 mm Volar Locking Compression Plates in Distal Radius Fractures
Ki-Chul Park, Chang-Hun Lee
Journal of the Korean Fracture Society.2009; 22(4): 264. CrossRef

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