A prospective study to assess the functional outcome of AO Type 23.B3 distal radius fractures treated with volar locking plate osteosynthesis

Background: Various surgical treatment methods are available for unstable distal radius fractures. Clinical and radiological outcome with volar locking plate has been very satisfactory. The purpose of this prospective study is to evaluate the results of the treatment of unstable fractures with the volar locking plate with regard to loss of reduction, functional outcome and complications. Methods: Unstable distal radius fractures were enrolled for the study from May 2008 until July 2010. All patients were treated with 3.5 mm distal radius volar locking plate and assessed by clinical and radiological examination. The clinical scoring chart modified by Cooney was used to evaluate the functional outcome. Results: Eighteen male and 12 female patients with the average age of 42.53 (range 30- 64years) were followed up for a period of 9 to 34 months (average.23 months). There were fourteen A3 fractures, nine C1 fractures, six C2 fractures, and one C3 fracture, whereas one had a Gustilo grade I open wound on the volar aspect. Seven of the fractures had associate fracture of the ulnar styloid. The functional outcome was excellent in 23 (76%), good in 6 (20%), fair in 1 (4%) and none had poor outcome. There were very few complications in our series. Conclusion: Unstable fractures of distal radius treated by open reduction with volar locking plate provides adequate fixation with no collapse in reduction and also have satisfactory functional outcome with minimal complications. DOI: http://dx.doi.org/10.3126/noaj.v2i1.8137 Nepal Orthopaedic Association Journal Vol.2(1) 2011: 27-34

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Functional Outcome and Complications at 2.5 Years Following Volar Locking Plate Fixation of Distal Radius Fractures

Journal of Hand and Microsurgery ◽

10.1007/s12593-014-0155-1 ◽

2016 ◽

Vol 07 (01) ◽

pp. 18-24 ◽

Cited By ~ 10

Author(s):

Robert MacFarlane ◽

David Miller ◽

Lynn Wilson ◽

Carl Meyer ◽

Cronan Kerin ◽

...

Keyword(s):

Functional Outcome ◽

Distal Radius ◽

Locking Plate ◽

Plate Fixation ◽

Distal Radius Fractures ◽

Volar Locking Plate ◽

Radius Fractures ◽

Locking Plate Fixation

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COMPARATIVE STUDY EVALUATING OUTCOMES OF CONSERVATIVE VERSUS VOLAR LOCKING PLATE OSTEOSYNTHESIS FOR UNSTABLE DISTAL RADIUS FRACTURES

10.36106/ijar/4600486 ◽

2020 ◽

pp. 9-11

Author(s):

Abhimanyu Kakralia ◽

Zakir Hussain ◽

Amit Jain ◽

R.C. Meena

Keyword(s):

Comparative Study ◽

Distal Radius ◽

Locking Plate ◽

Plate Osteosynthesis ◽

Functional Results ◽

Distal Radius Fractures ◽

Volar Locking Plate ◽

Radius Fractures ◽

Conservative Group ◽

Prospective Comparative Study

Background: The objective of the study was to compare the results of conservative management and volar locking plate by assessing the functional and radiological parameters using Stewart et al. system (1) and Sarmiento’s modification of Gartland and Werley scores (2) respectively in cases of unstable distal radius fractures. Materials & Methods: This was a prospective comparative study, which included 50 cases of distal radius fractures with 32 cases in the conservative group and 18 cases in the operative group. Radiographic and functional outcomes were assessed at 2 weeks, 3 months and 6 months using Stewart et al. system and Sarmiento’s modification of Gartland and Werley scores respectively. Results: In operative group, radiological results were well to excellent results in 100% of the patients while in conservative group, 30% had excellent results, 17% had good results and 53% had fair result. At 6 months after surgery, functional results in both groups were improved. In operative group, 100% had excellent results while in conservative group 48% had excellent, 44.44% had good, and 7% had fair results. Conclusion: This study shows that volar locking plates evidently has better results in terms of achieved faster and accelerated functional recovery.

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Prospective Study of Distal Radius Fractures Treated With a Volar Locking Plate System

Yearbook of Hand and Upper Limb Surgery ◽

10.1016/s1551-7977(09)79207-6 ◽

2009 ◽

Vol 2009 ◽

pp. 93-94

Author(s):

C. Carroll

Keyword(s):

Prospective Study ◽

Distal Radius ◽

Locking Plate ◽

Distal Radius Fractures ◽

Volar Locking Plate ◽

Radius Fractures ◽

Locking Plate System ◽

Plate System

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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

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04784-7 ◽

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.

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Functional outcome of volar locking plate for unstable distal radius fractures

Journal of Chitwan Medical College ◽

10.3126/jcmc.v8i3.23749 ◽

2018 ◽

Vol 8 (3) ◽

pp. 38-44

Author(s):

Bishnu Dev Sharma ◽

Akesh Prajapati ◽

Ananda Prasad Regmi ◽

Jyoti Sitaula ◽

Sujit Shrestha ◽

...

Keyword(s):

Functional Outcome ◽

Distal Radius ◽

Locking Plate ◽

Distal Radius Fractures ◽

Locking Plates ◽

Volar Locking Plate ◽

Radius Fractures ◽

Medical College ◽

Loss Of Reduction ◽

One Year

Introduction: Distal radius fractures are the most common fractures in elderly. Unstable fractures are best managed surgically and the results of volar locking plates have been promising. The purpose of this study is to determine the functional outcome of volar locking plates in the treatment of unstable distal radius fractures. Methods: Forty-five patients with 46 unstable distal radius fractures were enrolled for this study, conducted at Chitwan Medical College from September 2016 to April 2017. All patients were treated with a 3.5mm titanium volar locking plate and followed-up for a minimum of one year. The assessment was done using radiological evaluation and Cooney modification of the Green and O’Brien scoring system. Results: Twenty-three men and 22 women with age ranging from 15-75 years (mean 43.22 years) were followed-up for an average of 16.53 months. There were 17 type A fractures (5 A2, 12 A3), 11 type B fractures (3 B1, 1 B2, 7 B3), and 18 type C fractures (4 C1, 12 C2, 2 C3) (AO classification). The mean time for union was 7.96 weeks. Functional outcome using modified Green and O’Brien Score was 20 excellent, 15 good, 7 fair and 4 poor results (76.1% good to excellent results). The overall complication rate was 15.22%. Conclusion: Volar locking plates provide adequate fixation for unstable distal radius fractures with minimal loss of reduction and satisfactory functional outcome.

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