(1) Background: Different distal radial fracture types have different prognosis after fixation. Our study aim is to evaluate the differences in radiographic parameters by using variable-angle volar locking plate (VAVLP) fixation according to extra-articular and intra-articular distal radial fracture. (2) Methods: There are two groups: extra-articular group (21) and intra-articular group (25). Forearm radiographs immediately after surgery and at 3 months after operation were reviewed for analyzing radial height (RH), ulnar variance (UV), radial inclination (RI), volar tilt (VT), tear drop angle (TDA), distal dorsal cortical distance (DDD), and Soong classification (SC). (3) Results: There were no significant differences in the above parameters between two groups at either immediately post-operative or at 3-month follow-up, except for TDA (p = 0.048). Most patients in both groups were at low risk of flexor tendon rupture, except for two cases. We observed a positive correlation between post-operative DDD and 3-month change in the intra-articular group, but not the extra-articular group. (4) Conclusions: Our study demonstrates that VAVLP fixation is effective in maintaining the stability of most radiographic parameters and reduces the risk of tendon rupture in both extra-articular and intra-articular distal radial fractures. Post-operative DDD can be used to predict the degree of subsequent displacement in patients with intra-articular fractures fixed with VAVLP.

Background Reduction loss is commonly seen even in the newly designed locking plate fixation for distal radius fractures. Our study purpose is to investigate the efficacy of the variable angle volar locking plate (VAVLP) in maintenance of fracture fixation. Methods A total of 37 patients of unilateral distal radius fractures receiving VAVLP fixation were enrolled. Forearm radiographs immediately after surgery and those at 3 months were retrospectively reviewed by orthopedist, radiologist and medical students for analysis of radiographic parameter including radial height (RH), ulnar variance (UV), radial inclination (RI), volar tilt (VT), tear drop angle (TDA), distal dorsal cortical distance (DDD) and Soong classification (SC). Results By comparing the 3-month measurement and normal data, the difference of RH / UV / TDA was significant (p-value of 0.000) while the difference of RI / VT was insignificant. However, there was no significant difference regarding those five parameters between postoperative and 3-month measurement. Linear regression on DDD exhibited positive dependence with p-value of 0.002 between postoperative and 3-month changes; predictability after modification was 21.3%. Postoperative SC was grade 0 in 13 patients, grade 1 in 21, and grade 2, in 3. There were 7 of Gr 0 and 2 of Gr 1 became one grade up.Conclusion VAVLP fixation in distal radius fracture can maintain radiographic alignment without significant reduction loss for at least 3 months. Realignment within normal range was in RI and VT, but not in RH / UV / TDA.