Comparative clinical study of locking screws versus smooth locking pegs in volar plating of distal radius fractures

Abstract

The present study was performed to test the null hypothesis on no difference in stability of fixation after volar plating of intra-articular distal radius fractures (AO C2-C3) with either locking smooth pegs or locking screws in a clinical setting. A retrospective evaluation included adult patients with C2-C3 AO fractures treated with a volar plate with locking smooth pegs or locking screws. Radiographic assessment was performed to evaluate extra- and intra-articular parameters in the early postoperative period and after bone union. Twenty-seven consecutive patients were included. Thirteen cases had fixation with locking screws and 14 had fixation with locking smooth pegs. Both groups had bone fragment displacement after fixation. However, there were no significant differences between the groups either in extra- or intra-articular parameters defined by Kreder et al. (1996). Our study shows that, in a clinical setting, there is no difference in stability fixation between locking screws or smooth locking pegs in C2-C3 distal radius fractures.

Volar Plate Fixation in Patients Older Than 70 Years with AO Type C Distal Radial Fractures: Clinical and Radiologic Outcomes

“…Direct reduction using the plate as a template was performed in all fractures, and either locking pins or locking screws were placed to fix the subchondral bone. 12,13 Distal double row VLPs of different manufactures were used (Aculok VDR Plate, Acumed, Hillsboro, OR; DVR-Hand Innovations, Biomet, Warsaw, IN; VariAx Distal Radius Locking Plate, Stryker, Kalamazoo, MI). No additional bone grafting was used in this series of patients.…”

“…Major complications included deep infections, nerve or tendon injury, and hardware loosening or failure that led to reoperation. 11,13,[19][20][21][22][23] The statistical analysis was performed using STATA 12 software (StataCorp LP, College Station, TX). A p value of less than 0.05 was considered statistically significant.…”

DVR plating of distal radius fractures

“…The blunt tips do not harm tendons even if these protrude dorsally. Due to the anatomical orientation of the pegs, fixation and support of the fragments is just as good as with screws [11].…”

Distal radial fractures

“…25 Biomechanical studies over the past several years have found that locking screws impart greater construct stability than pegs. Theoretically, pegs provide lower risk of intraarticular penetration and have a larger core diameter to better resist bending stress, while screws provide greater pullout strength.…”

“…Theoretically, pegs provide lower risk of intraarticular penetration and have a larger core diameter to better resist bending stress, while screws provide greater pullout strength. Boretto et al 25 performed a retrospective review of 27 patients with AO C2-C3 fractures treated with either locking screws or smooth locking pegs, and found no significant difference in stability of fixation. 26 However, clinical evidence of the significance of these findings on patient outcome is lacking.…”