gms | German Medical Science

Objectives/Interrogation: Fractures of the wrist account for 25-36% of all pediatric fractures. Although pediatric fractures have remodeling potential, unstable fractures and fractures with a rotational deformity require reduction and fixation. More invasive volar plate fixation is less popular in pediatric patients. However, volar plate fixation enhances anatomic reduction and allows for functional postoperative treatment. This may lead to less redislocations, malunions, and improved functional outcome. To the best of our knowledge, only one case study is available which describes volar plate fixation for a displaced distal radius fracture in a 13-year old child.

The purpose of this study was to present the functional outcomes of pediatric patients treated with volar plate fixation for unstable displaced distal radius fractures.

Methods: In this retrospective observational cohort all pediatric patients surgically treated for unstable distal radius fractures between September 2010 and July 201 were reviewed. Patients aged between 4 and 17 years treated with volar plate fixation were included.

The primary outcome was the Patient Rated Wrist Evaluation (PRWE) after at least 12 months follow-up. Secondary outcomes were range of motion and grip strength compared to the uninjured wrist, postoperative radiological parameters, complication and incidence of plate removal.

Results and Conclusions: A total of 26 patients with a median age of 12.5 years were included. Median PRWE was 3 after a median follow-up of 29 months. range of motion and grip strength did not differ significantly between the injured and uninjured wrist. in two patients stiffness was reported as a complication, which was successfully treated with physical therapy. No wound infections were found. Plate removal was performed in 15 patients.

Volar plate fixation for unstable displaced distal radius fractures in children provides excellent functional outcomes.