Functional Outcome In Distal Radius Fracture With Diaphyseal Involvement Fixed With Fixed Angle Volar Plate

Aim and objectives: This study is to assess the functional outcome of patients with metaphyseal and diaphyseal fractures of distal radius treated with fixed angle volar plate.

MATERIALS AND METHODS: 30 patients with metaphyseal and diaphyseal distal radius fractures were managed with fixed angle volar plate. The standard Henrys approach was used. In 22 patients, long fixed angular plate and screws was used and in 8 patients, long fixed angular plate and k wire was used for co-existing ulnar fractures. Radiograph, physical examination, Wrist ROM (range of movements), Grip strength, Disability of arm shoulder and hand score (DASH score) and Mayo wrist score was assessed at 30 days, 60 days, 90 days and 120 days prospectively after surgery.

RESULT: Average time required to heal for all cases were 90 days. Bone grating was done in 1 case to achieve union. Radio ulnar synostosis was seen in 1 case. 23 of 30 cases showed optimum reduction, with neutral ulnar variance and normal radial length. Mean ROM at the end of 1 year was 68.17 (5.33) flexion, extension 80.33 (5.24), pronation 85.33 (4.54) and supination 85.33 (4.54). They were found to be significant (P < 0.00001). DASH score was averagely 4 at end of 30 days and 3 during follow up periods. MAYO wrist score showed excellent outcomes in 22 cases, good outcomes in 6 cases, fair outcomes in 1 case and poor outcomes in 1 case at the end of 4 months. DASH score and MAYO wrist score were found to be significant (P < 0.00001). Grip strength improved from 64.83 % to 85.20% at end of 4 months and was found to be significant (P < 0.00001)

CONCLUSION: In these challenging fractures, fixed angle volar plates are safe and efficient mode of treatment