Biomechanical Analysis of a Volar Variable-Angle Locking Plate: The Effect of Capturing a Distal Radial Styloid Fragment

Stanbury, Spencer J.; Salo, Art D.; Elfar, John C.

doi:10.1016/j.jhsa.2012.09.009

Cited by 33 publications

(21 citation statements)

References 37 publications

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“…In this study, RI in the DSS group was better maintained than in the non-DSS group. Stanbury et al showed the superiority of a variable-angle locking plate for capturing a distal radial styloid compared with a fixed-angle plate in biomechanical study [ 12 ]. A variable locking plate using the DSS procedure might capture a distal radial styloid fragment better than a non-DSS procedure.…”

Section: Discussionmentioning

confidence: 99%

Variable-angle locking plate with or without double-tiered subchondral support procedure in the treatment of intra-articular distal radius fracture

Kawasaki

Nemoto

Inagaki

et al. 2014

J Orthopaed Traumatol

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BackgroundDouble-tiered subchondral support (DSS) procedure is two-row fixation in which proximal screws support the dorsal subchondral bone, whereas distal screws support the volar central subchondral bone, using the volar variable-angle locking plate to achieve better anatomical reduction. We examined whether DSS improves clinical outcome, complication rate, and loss of correction for dorsally displaced Arbeitsgemeinschaft für Osteosynthesefragen (AO) type C3 distal radius fractures.Materials and methodsWe reviewed dorsally displaced intra-articular AO C3-type distal radius fractures treated at our institutions with a variable-angle volar locking plate. We assessed 49 patients (27 DSS; 22 non-DSS) treated with volar locking plates, with a mean age of 59.9 years and average follow-up of 20.2 months (range 12–56 months). We evaluated differences in functional outcome, complication rates, and loss of correction between groups using radiographic parameters.ResultThere were no differences in clinical outcome and complications. Final volar tilt and ulnar variance were better maintained in the DSS group (P = 0.01 and 0.03). Change in volar tilt of the non-DSS group was more than that of the DSS group (P = 0.00).ConclusionThough there were no significant differences in clinical outcomes, we identified a significant reduction in final volar tilt, ulnar variance, and change in volar tilt. DSS procedure is useful to avoid correction loss when treating unstable C3 distal radius fractures and thus would reduce posttraumatic arthrosis.Level of evidenceLevel IV.

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Section: Discussionmentioning

confidence: 99%

Variable-angle locking plate with or without double-tiered subchondral support procedure in the treatment of intra-articular distal radius fracture

Kawasaki

Nemoto

Inagaki

et al. 2014

J Orthopaed Traumatol

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“…The evaluation of our results according to Gartland and Werley’s demerit scoring system revealed that 65.22% patients had excellent results, while 34.78% fell into the good results category ( Figure 5 ). Figl et al reported excellent results in 37.5% of patients, good results in 67%, and fair results in 1% ( 22 ). Jagodzinski et al reported a mean DASH (disabilities of the arm, shoulder, and hand) score of 18.2 in patients treated with VALP ( 28 ).…”

Section: Discussionmentioning

confidence: 97%

“…There were concerns regarding the biomechanical rigidity of variable angle locking plates in comparison to fixed-angle plates. Stanbury et al showed that the volar fixed and variable angle locking plates were similar in terms of the mean load to failure on cyclical loading ( 22 ). The physiological compressive loads during movement of the wrist can easily be tolerated with VALPs.…”

Section: Discussionmentioning

confidence: 99%

“…The adaptation of screw direction helps in engaging specific fracture fragments and avoiding intraarticular penetration. Stanbury et al reported the superiority of variable angle volar locking plates over fixed-angle locking plates in capturing the distal radial styloid ( 22 ). However, in our case series, three cases required additional measures to stabilize the unstable distal end radius fracture.…”

Section: Discussionmentioning

confidence: 99%

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Surgical Treatment of Unstable Distal Radius Fractures With a Volar Variable-Angle Locking Plate: Clinical and Radiological Outcomes

Khatri

Farooque

et al. 2016

Arch Trauma Res

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BackgroundUnstable distal end radius fractures are difficult to manage and so various treatment modalities have been described. The use of variable-angle locking plates is promoted for the management of these fractures.ObjectivesThis study aimed to evaluate the functional and radiological outcomes in unstable distal end radius fractures treated with variable-angle locking plates.Patients and MethodsWe reviewed 23 unstable distal end radius fractures that were treated at our institution with volar variable-angle locking plates. The mean age of the patients was 32.82 ± 11.81 years (range 19 to 62) and the mean duration of follow-up was 11.04 ± 2.47 months (range 6 to 15). All of the patients underwent open reduction and internal fixation with a variable-angle locking plate. Radiological parameters such as radial inclination, length, tilt, and ulnar variance were measured at six weeks and at the final follow-up. The functional evaluation was conducted by measuring the range of motion at the wrist joint as well as the grip strength. Gartland and Werley’s demerit scoring system was used to assess the final outcome.ResultsThere were two cases of superficial infection that responded to oral antibiotics. One patient had developed a hypertrophic scar, while another had carpal tunnel syndrome that was conservatively managed. There was a significant improvement in the functional indices from six weeks to the final follow-up, while the radiological parameters were maintained. According to Gartland and Werley, excellent results were reported in 65.2% cases, while good results were present in 35% cases.ConclusionsThe use of variable-angle locking plates in treating unstable distal end radius fractures is associated with excellent to good functional outcomes with minimal complications.

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“…27 A bio mechanical study by Stanbury et al expressed superiority of a variable angle volar locking plate for capturing a distal radial styloid fragment compared to fixed angle plate. 28 Rogachefsky et al used open reduction with combination of external fixation for AO type C fractures and found that this provides satisfactory function and can restore radiological parameters. Open reduction and internal fixation with volar plate is a practiced surgical procedure for volar angulated distal radius fractures.…”

Section: Discussionmentioning

confidence: 99%

A comparative study between variable and fixed angle volar locking plates in management of unstable intra-articular distal radius fractures

et al. 2020

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Background: The current study is conducted to assess and compare the radiological and functional outcomes between variable and fixed angle volar plating in unstable intra-articular distal radius fractures.Methods: A prospective study was conducted from May 2018 to May 2020. A total of 156 patients were randomised into two groups A and B of 78 patients each. The plates were T or oblique fixed angle volar plate in group A and variable angle volar plate in group B. Patients were followed up for minimum 12 months. The functional outcome was measured by patient rated hand wrist evaluation score (PRHWE) and radiological outcome by radial height, volar tilt and radial inclination. The secondary objective was to correlate complications.Results: In our study average PRHWE score was better in group B (p<0.05). Radial height, volar tilt, radial inclination was much closer to anatomical wrist radiology was seen in group B. The most common complication was finger and wrist stiffness in group A.Conclusions: Patients treated with variable angle volar plate showed better results in functional and radiological outcomes at 12 months follow-up but limitations include short duration of follow up.

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Biomechanical Analysis of a Volar Variable-Angle Locking Plate: The Effect of Capturing a Distal Radial Styloid Fragment

Cited by 33 publications

References 37 publications

Variable-angle locking plate with or without double-tiered subchondral support procedure in the treatment of intra-articular distal radius fracture

Variable-angle locking plate with or without double-tiered subchondral support procedure in the treatment of intra-articular distal radius fracture

Surgical Treatment of Unstable Distal Radius Fractures With a Volar Variable-Angle Locking Plate: Clinical and Radiological Outcomes

A comparative study between variable and fixed angle volar locking plates in management of unstable intra-articular distal radius fractures

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