An Evaluation of Variable-Angle Volar Locking Plate for Distal Radius Fractures
Authors/Creators
- 1. M. S. Ortho, Associate Professor, Prasad Institute of Medical Sciences Lucknow
Description
Introduction: This study is regarding the fracture of distal end of radius and its management. There are several treatment modalities available for fracture distal end radius. Complication rate with majority of modalities is very high. The prevalence of radius fracture at distal end was reported to be about 37 for every 10,000 person-years among female population while in male population it is about 9 for every 10,000 person-years over the age of 35 years. It was proposed that volar locking plate is better to improve patient’s outcome in terms of radiological parameters and also to increase the range of motion. Several volar and dorsal plates are available for managing the distal radius fractures in the India. This can be classified as fixed-angle locking plates, non-locking and recently available variable angle locking plates. Aims and Objectives: To evaluate the outcome of applying variable angle locking plates in comparison to existing treatment modalities in terms of improvement in radiological parameters and functional outcome. Materials and Methods: In this retrospective study, patients with distal radius fractures treated with variable angle locking plate were considered. The outcome parameters for analysis were determined at different follow up time i.e. immediate post op, at 8th week and 6 months after operation. Results: The study found that the improvement in radiological picture and functional movements were significantly better (p>0.05) and suggest to use volar variable angle locking plate as better alternative than ORIF and fixing with fixed angle locking plate. Gartland and Werley’s scores also came to be excellent with 73.52% of patients. Conclusion: The study has concluded that variable angle volar locking plate can be used with lower complication rate and should be considered in the guidelines to be used as better treatment modality to the existing treatment modalities.
Abstract (English)
Introduction: This study is regarding the fracture of distal end of radius and its management. There are several treatment modalities available for fracture distal end radius. Complication rate with majority of modalities is very high. The prevalence of radius fracture at distal end was reported to be about 37 for every 10,000 person-years among female population while in male population it is about 9 for every 10,000 person-years over the age of 35 years. It was proposed that volar locking plate is better to improve patient’s outcome in terms of radiological parameters and also to increase the range of motion. Several volar and dorsal plates are available for managing the distal radius fractures in the India. This can be classified as fixed-angle locking plates, non-locking and recently available variable angle locking plates. Aims and Objectives: To evaluate the outcome of applying variable angle locking plates in comparison to existing treatment modalities in terms of improvement in radiological parameters and functional outcome. Materials and Methods: In this retrospective study, patients with distal radius fractures treated with variable angle locking plate were considered. The outcome parameters for analysis were determined at different follow up time i.e. immediate post op, at 8th week and 6 months after operation. Results: The study found that the improvement in radiological picture and functional movements were significantly better (p>0.05) and suggest to use volar variable angle locking plate as better alternative than ORIF and fixing with fixed angle locking plate. Gartland and Werley’s scores also came to be excellent with 73.52% of patients. Conclusion: The study has concluded that variable angle volar locking plate can be used with lower complication rate and should be considered in the guidelines to be used as better treatment modality to the existing treatment modalities.
Files
IJPCR,Vol14,Issue10,Article94.pdf
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Additional details
Dates
- Accepted
-
2022-10-12
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/14/IJPCR,Vol14,Issue10,Article94.pdf
- Development Status
- Active
References
- 1. Xavier CR, Dal Molin DC, Dos Santos RM, Dos Santos RD, Neto JC. Surgical Treatment of Distal Radius Fractures with a Volar Locked Plate: Correlation of Clinical and Radiographic Results. Rev Bras Ortop. 2011;46(5):505–13. 2. Ismail AA, Pye SR, Cockerill WC, et al. Incidence of limb fracture across Europe: results from the European Prospective Osteoporosis Study (EPOS). Osteoporos Int 2002; 13(7): 565–71. 3. Variable-Angle Volar Plating 379 2. Chung KC, Spilson SV. The frequency and epidemiology of hand and forearm fractures in the United States. J Hand Surg Am 2001;26(5):908–15. 4. Arora R, Gabl M, Gschwentner M, Deml C, Krappinger D, Lutz M. A comparative study of clinical and radiologic outcomes of unstable colles type distal radius fractures in patients older than 70 years: nonoperative treatment versus volar locking plating. J Orthop Trauma. 2009;23(4):237–42. 5. Wong KK, Chan KW, Kwok TK, Mak KH. Volar fixation of dorsally displaced distal radial fracture using locking compression plate. J Orthop Surg (Hong Kong). 2005; 13(2): 153– 7. 6. Cummings SR, Black DM, Rubin SM. Lifetime risks of hip, Colles', or vertebral fracture and coronary heart disease among white postmenopausal women. Arch Intern Med. 1989; 149(11): 2445e2448. 7. Chen NC, Jupiter JB. Management of distal radial fractures. JBJS. 2007 Sep 1;89(9):2051-62. 8. Chung KC, Spilson SV. The frequency and epidemiology of hand and forearm fractures in the United States. J Hand Surg Am. 2001;26(5):908e915. 9. Rausch S, Klos K, Gras F, Skulev HK, Popp A, Hofmann GO, et al. Utility of the cortical thickness of the distal radius as a predictor of distal-radius bone density. Arch Trauma Res. 2013;2(1):11–5. 10. Kakarlapudi TK, Santini A, Shahane SA, Douglas D. The cost of treatment of distal radial fractures. Injury. 2000;31(4):229e232. 11. Jupiter JB, Marent-Huber M. Operative management of distal radial fractures with 2.4-millimeter locking plates. A multicentre prospective case series. J Bone Joint Surg Am 2010;92(1):96– 106 12. Chung KC, Watt AJ, Kotsis SV, Margaliot Z, Haase SC, Kim HM. Treatment of unstable distal radial fractures with the volar locking platingsystem. J Bone Joint Surg Am. 2006;88(12):2687e2694. 13. Ring D, Jupiter JB, Brennwald J, Büchler U, Hastings H. Prospective multicenter trial of a plate for dorsal fixation of distal radius fractures. J Hand Surg Am. 1997; 22(5):777–84. 14. Protopsaltis TS, Ruch DS. Volar fixedangle plating of the distal radius. J Hand Surg Am 2008;33(6): 958–65. 15. Rohde G, Haugeberg G, Mengshoel AM, et al. No long-term impact of low-energy distal radius fracture on health-related quality of life and global quality of life: a case–control study. BMC Musculoskelet Disord 2009; 10:106. 16. Koenig KM, Davis GC, Grove MR, et al. Is early internal fixation preferred to cast treatment for well reduced unstable distal radial fractures? J Bone Joint Surg Am 2009;91(9):2086–93. 17. Nana AD, Joshi A, Lichtman DM. Plating of the distal radius. J Am Acad Orthop Surg 2005;13(3):159–71. 18. Osada D, Viegas SF, Shah MA, Morris RP, Patterson RM. Comparison of different distal radius dorsal and volar fracture fixation plates: a biomechanical study. J Hand Surg Am. 2003;28(1):94e104. 19. Smith D, Henry M. Volar fixed-angle plating of the distal radius. J Am Acad Orthop Surg 2005;13(1): 28–36. 20. Catalano LW 3rd, Cole RJ, Gelberman RH, et al. Displaced intra-articular fractures of the distal aspect of the radius. Long-term results in young adults after open reduction and internal fixation. J Bone Joint Surg Am 1997;79(9):1290–302. 21. Cole RJ, Bindra RR, Evanoff BA, Gilula LA, Yamaguchi K, Gelberman RH. Radiographic evaluation of osseous displacement following intraarticular fractures of the distal radius: reliability of plain radiography versus computed tomography. J Hand Surg Am. 1997;22(5):792e800. 22. Liporace FA, Gupta S, Jeong GK, et al. A biomechanical comparison of a dorsal 3.5-mm T-plate and a volar fixed-angle plate in a model of dorsally unstable distal radius fractures. J Orthop Trauma. 2005;19(3):187e191. 23. Park JH, Hagopian J, Ilyas AM. Variable-angle locking screw volar plating of distal radius fractures. Hand Clinics. 2010 Aug 1;26(3):373-80. 24. Jagodzinski NA, Singh T, Norris R, Jones J, Power D, editors. Early results of a variable-angle volar locking plate for distal radius fractures: A bi-centre study. Orthopaedic Proceedings. 2012; Orthopaedic Proceedings. 25. Weninger P, Schueller M, Drobetz H, et al. Influence of an additional locking screw on fracture reduction after volar fixed-angle plating-introduction of the protection screw in an extra-articular distal radius fracture model. J Trauma 2009;67(4):746–51. 26. Smith D, Henry M. Volar fixed-angle plating of the distal radius. J Am Acad Orthop Surg 2005;13(1): 28–36. 27. Mignemi ME, Byram IR, Wolfe CC, et al. Radiographic outcomes of volar locked plating for distal radius fractures. J Hand Surg Am. 2013;38(1):40e48. 28. Orbay JL, Fernandez DL. Volar fixedangle plate fixation for unstable distal radius fractures in the elderly patient. J Hand Surg Am. 2004;29(1):96e102. 29. Margaliot Z, Haase SC, Kotsis SV, Kim HM, Chung KC. A meta-analysis of outcomes of external fixation versus plate osteosynthesis for unstable distal radius fractures. J Hand Surg Am. 2005; 30(6):1185–99. 30. Kanabar P, Mirza S, Hallam P, Cooper A. Volar locking plate for distal radius fractures: does it do what it says on the box? A radiological review of 170 consecutive distal radius fractures treated with a volar locking plate. J Bone Joint Surg Br. 2011:93. 31. Levin SM, Nelson CO, Botts JD, Teplitz GA, Kwon Y, Serra-Hsu F. Biomechanical evaluation of volarlocking plates for distal radius fractures. Hand (N Y). 2008;3(1):55– 60. 32. Gruber G, Gruber K, Giessauf C, Clar H, Zacherl M, Fuerst F, et al. Volar plate fixation of AO type C2 and C3 distal radius fractures, a single enter study of 55 patients. J Orthop Trauma. 2008; 22(7):467–72. 33. Rozental TD, Blazar PE. Functional outcome and complications after volar plating for dorsally displaced, unstable fractures of the distal radius. J Hand Surg Am. 2006;31(3):359–65. 34. 21. Orbay JL, Fernandez DL. Volar fixed-angle plate fixation for unstable distal radius fractures in the elderly patient. J Hand Surg Am. 2004; 29(1): 96–102. 35. Stanbury SJ, Salo A, Elfar JC. Biomechanical analysis of a volar variable-angle locking plate: the effect of capturing a distal radial styloid fragment. J Hand Surg Am. 2012; 37(12): 2488–94. 36. Figl M, Weninger P, Liska M, Hofbauer M, Leixnering M. Volar fixed angle plate osteosynthesis of unstable distal radius fractures: 12 months' results. Arch Orthop Trauma Surg. 2009;129(5):661–9. 37. Asadollahi S, Keith PP. Flexor tendon injuries following plate fixation of distal radius fractures: a systematic review of the literature. J Orthop Traumatol. 2013;14(4):227–34. 38. Couzens GB, Peters SE, Cutbush K, Hope B, Taylor F, James CD, et al. Stainless steel versus titanium volar multi-axial locking plates for fixation of distal radius fractures: a randomised clinical trial. BMC Musculoskelet Disord. 2014; 15:74. 39. Jagodzinski NA, Singh T, Norris R, Jones J, Power D, editors. Early results of a variable-angle volar locking plate for distal radius fractures: A bi-centre study. Orthopaedic Proceedings. 2012; Orthopaedic Proceedings. 40. Kawasaki K, Nemoto T, Inagaki K, Tomita K, Ueno Y. Variable-angle locking plate with or without doubletiered subchondral support procedure in the treatment of intra-articular distal radius fracture. J OrthopTraumatol. 2014;15(4):271–4. 41. MacDermid JC, Roth JH, Richards RS. Pain and disability reported in the year following a distal radius fracture: a cohort study. BMC Musculoskelet Disord. 2003; 4:24. 42. Weninger P, Schueller M, Drobetz H, et al. Influence of an additional locking screw on fracture reduction after volar fixed-angle plating-introduction of the protection screw in an extra-articular distal radius fracture model. J Trauma 2009;67(4):746–51. 43. IJ O., J O. J., & U O. B. Evaluation of the Effectiveness of Intra-operative Low Dose Ketamine Infusion on Postoperative Pain Management Following Major Abdominal Gynaecological Surgeries. Journal of Medical Research and Health Sciences, 2022; 5(10): 2269–2277.