scholarly journals Volar Locking Plate Fixations for Displaced Distal Radius Fractures: An Evaluation of Complications and Radiographic Outcomes

Hand ◽  
2017 ◽  
Vol 13 (4) ◽  
pp. 466-472 ◽  
Author(s):  
James Wilson ◽  
Jeremy J. Viner ◽  
Kavan S. Johal ◽  
Michael J. Woodruff
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Distal Radius Fractures ◽  
Complication Rates ◽  
Volar Locking Plate ◽  
Radius Fractures ◽  
Time To Surgery ◽  
Radiographic Outcomes ◽  
Plate Design

Background: A volar locking plate (VLP) is the most frequently used form of implant used for open reduction and internal fixation of distal radius fractures. They are known to have a complication rate of up to 27%. We hypothesized that plate design could influence complication rates. Methods: We performed a review of patients undergoing VLP fixation for distal radius fracture. A total of 228 patients underwent fixation with the Distal Volar Radial Anatomical (DVR) plate; 388 patients underwent fixation with the VariAx plate. Independent observers performed blinded case note and radiographic review, to assess for the quality of reduction, and complications for the inserted VLP. Results: Mean time to surgery was 6.0 days; mean follow-up was 17.5 weeks. Mean age was 56.5 years. The quality of reduction was classified as anatomical (46%), good (36.3%), moderate (13.0%), or poor (3.9%). Complications were identified in 109 patients (17%). Plate prominence was seen in 133 patients (21%). The DVR plate was less prominent ( P < .001) and had better overall radiographic appearances ( P = .025). Flexor tendon complications were related to plate prominence ( P = .005). Inferior reduction was associated with increased time to surgery ( P = .020). Conclusions: This study highlights the importance of prompt surgery, effective fracture reduction, and careful plate positioning to avoid volar prominence.

scholarly journals Comparison of a ceiling-mounted 3D flat panel detector vs. conventional intraoperative 2D fluoroscopy in plate osteosynthesis of distal radius fractures with volar locking plate systems

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Raphael Seuthe ◽  
Andreas Seekamp ◽  
Bodo Kurz ◽  
Julian Pfarr ◽  
Jost Philipp Schaefer ◽  
...  
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Plate Osteosynthesis ◽  
Distal Radius Fractures ◽  
Fracture Reduction ◽  
Volar Locking Plate ◽  
Radius Fractures ◽  
Flat Panel ◽  
Flat Panel Detector

Abstract Objectives To compare intraoperative 3D fluoroscopy with a ceiling-mounted flat panel detector in plate osteosynthesis of distal radius fractures (AO/OTA 2R3C1.2) with volar locking plate systems to conventional 2D fluoroscopy for detection of insufficient fracture reduction, plate misplacement and protruding screws. Methods Using a common volar approach on 12 cadaver forearms, total intraarticular distal radius fractures were induced, manually reduced and internally fixated with a 2.4 distal radius locking compression plate. 2D (anterior-posterior and lateral) and 3D (rotational) fluoroscopic images were taken as well as computed tomographies. Fluoroscopic images, Cone Beam CT (CBCT), 360° rotating sequences (so called “Movies”) and CT scans were co-evaluated by a specialist orthopedic surgeon and a specialist radiologist regarding quality of fracture reduction, position of plate, position of the three distal locking screws and position of the three diaphyseal screws. In reference to gold standard CT, sensitivity and specifity were analyzed. Results “Movie” showed highest sensitivity for detection of insufficient fracture reduction (88%). Sensitivity for detection of incorrect position of plate was 100% for CBCT and 90% for “Movie.” For intraarticular position of screws, 2D fluoroscopy and CBCT showed highest sensitivity and specifity (100 and 91%, respectively). Regarding detection of only marginal intraarticular position of screws, sensitivity and specifity of 2D fluoroscopy reached 100% (CBCT: 100 and 83%). “Movie” showed highest sensitivity for detection of overlapping position of screws (100%). When it comes to specifity, CBCT achieved 100%. Regarding detection of only marginal overlapping position of screws, 2D fluoroscopy and “Movie” showed highest sensitivity (100%). CBCT achieved highest specifity (100%). Conclusion As for assessment of quality of fracture reduction and detection of incorrect position of plate as well as overlapping position of the three diaphyseal screws CBCT and “Movie” are comparable to CT – especially when combined. Particularly sensitivity is high compared to standard 2D fluoroscopy.

scholarly journals Complications of Volar Plating of Distal Radius Fractures: A Systematic Review

2018 ◽  
Vol 08 (03) ◽  
pp. 255-262 ◽  
Author(s):  
Todd H. Alter ◽  
Kristin Sandrowski ◽  
Gregory Gallant ◽  
Moody Kwok ◽  
Asif M. Ilyas
Keyword(s):  
Systematic Review ◽  
Distal Radius ◽  
Complication Rate ◽  
Locking Plate ◽  
Plate Fixation ◽  
Distal Radius Fractures ◽  
Complication Rates ◽  
Volar Locking Plate ◽  
Radius Fractures ◽  
Total N

Background In recent years, there has been an increased utilization of volar locking plate fixation of distal radius fractures (DRFs). However, reported long-term complication rates with this technique remain unclear. Purpose The purpose of this systematic review was to investigate the pooled incidence of complications associated with volar locking plating of DRF. Methods A search of the Scopus database was performed from 2006 through 2016. Studies were considered eligible if they had a diagnosis of a DRF and were treated with a volar locking plate with an average of 12 months or longer follow-up. Results The literature search yielded 633 citations, with 55 eligible for inclusion in the review (total n = 3,911). An overall complication rate of 15% was identified, with 5% representing major complications requiring reoperation. The most common complication types identified included nerve dysfunction (5.7%), tendon injury (3.5%), and hardware-related issues (1.6%). Conclusion Nerve complications were reportedly higher than tendon and hardware-related complications combined. However, despite varying complication rates in the literature, this systematic review reveals an overall low complication rate associated with volar locking plating of DRF.

Volar locking plate vs epibloc system for distal radius fractures in the elderly

Injury ◽  
2016 ◽  
Vol 47 ◽  
pp. S84-S90 ◽  
Author(s):  
Giuseppe Solarino ◽  
Giovanni Vicenti ◽  
Antonella Abate ◽  
Massimiliano Carrozzo ◽  
Girolamo Picca ◽  
...  
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
The Elderly ◽  
Distal Radius Fractures ◽  
Volar Locking Plate ◽  
Radius Fractures

scholarly journals Functional outcome in patients with unstable distal radius fractures, volar locking plate versus external fixation: a meta-analysis

2013 ◽  
Vol 8 (2) ◽  
pp. 67-75 ◽  
Author(s):  
J. C. Goslings ◽  
Monique M. J. Walenkamp ◽  
Abdelali Bentohami ◽  
M. Suzan H. Beerekamp ◽  
Rolf W. Peters ◽  
...  
Keyword(s):  
Functional Outcome ◽  
External Fixation ◽  
Distal Radius ◽  
Locking Plate ◽  
Meta Analysis ◽  
Distal Radius Fractures ◽  
Plate Versus ◽  
Volar Locking Plate ◽  
Radius Fractures

Distal radius fractures – A volar plate is not just a volar plate

Trauma ◽  
2017 ◽  
Vol 20 (3) ◽  
pp. 203-207
Author(s):  
Richard Knight ◽  
Lucy Elliott ◽  
Mark Brewster ◽  
Michelle Spiteri ◽  
Dominic Power
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Cost Savings ◽  
Fracture Pattern ◽  
Distal Radius Fractures ◽  
Volar Plate ◽  
Radius Fractures ◽  
Potential Cost ◽  
Plate Design ◽  
Column Variable

Introduction Increasingly complex distal radius plate designs are available for treating distal radius fractures. As a result, many fractures are being ‘over-treated’ with more complex volar plate designs than necessary. We hypothesise that significant cost savings could be made by rationalising the use of complex locking plate designs. Methods Over a two-year period, radiographs of 250 consecutive distal radius fractures fixed with volar locking plates were reviewed and the type of plate, and type and number of screws used for fixation were noted. Preoperative radiographs were independently reviewed to ascertain if it would have been possible to stabilise the fracture with a simpler, extra-articular plate design. Potential cost savings were then calculated. Results It was deemed that 89 (36.5%) of the 250 cases originally treated with a more complex 2 column variable angle plate could have been treated with an extra-articular construct, leading to potential savings of £19,224. Conclusion It is clear from our data that many distal radius fracture patterns are being ‘over-treated’ with complex locking plate designs with multiple rows of screws and that substantial cost savings could be made by selecting an appropriate construct to suit the fracture pattern.

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