gms | German Medical Science

Objectives/Interrogation: Distal radius fractures (DRF) are the most common occurring fractures in the upper extremities and the incidence is worldwide on the increase due to a growing population in the industrial countries. In the last decade there was significant change in stabilisation away from k-wires and external fixation to open reduction and locking plate fixation.

Due to the increased number of DRFs, stabilization methods and complications are of interest in the literature. Many studies reported up to 39% complication rates in volar stabilized DRF. Typical complications included: changes in sensibility, tendon irritation and rupture, hardware malfunction, infection, complex regional pain syndrome (CRPS), and post-traumatical osteoarthritis.

Methods: All patients with DRF that were stabilized between 2013 to 2016, using volar angular stable locking plate and minimum follow-up of 3 months were included. 392 patients medical records (259 female/133 male) with a mean follow-up interval of 11 months (range 3 to 52 months) were analyzed.

All recorded complications were documented. Range of motion (ROM) in extension, flexion, supination, pronation, radial- and ulnar deviation of the last follow-up was noted. Age was divided into younger than 65 years and equal or older than 65 years. The primary, postoperative and final checkup radiographs were analyzed for alignment and intra-articular step-off.

Results: A total of 51 (13%) early and 17 late (4%) complications were recorded patients. The most common complications included carpal tunnel syndrome (3%), complex regional pain syndrome (3%) and loss of reduction (2%). Of the 68 complications, only 23 (6%) were directly related to the plate and 73% of all complications occurred in AO type C fractures. Patients without complications showed a significantly better ROM in extension, flexion, pronation and supination than patients with complications. No significant differences in incidence of complications, ROM or loss of reduction could be found between patients over and under 65 years of age.

Conclusion: Treatment of DRF by volar angular stable locking plate is a safe and results in the majority of the cases a good clinical and radiological outcome with no complications. Age over 65 years is not associated with an increased risk for complications or restricted ROM.