Incidence for volar locking plate removal following distal radius fracture surgery

Abstract

Introduction Distal radius fracture is the most common fracture in adults. The most common treatment for distal radius fracture is non-operative cast immobilization, although there are injuries that require surgical treatment. During the past decade, studies have reported a large increase in the surgical treatment of distal radius fractures with open reduction and internal fixation using volar locking plates. The aim of this study was to investigate the incidence and trends for plate removal after plate fixation of distal radius fractures. Materials and methods The study covered all patients 18 years of age and older who had a surgically treated distal radius fracture with open reduction and internal fixation in Finland between 1998 and 2016. Patient data were obtained from the Finnish National Hospital Discharge Register. The association between increased number of platings and plate removals was examined by calculating the removal rates. The study population comprises all patients on a national level, and therefore we did not use statistical testing to analyze the data. Results A total of 18,298 patients had surgically treated distal radius fracture with volar plate in Finland during the 19-year study period from January 1, 1998 to December 31, 2016. The number of plate removal operations over the same time period was 2560. The removal rates decreased from over 20% in 1998 to less than 12% in 2016. The mean time period between plating and plate removal operations was 367 days. Most of the plate removals (n = 2235; 87.3%) were conducted during the first 2 years after plating. Conclusion Plate removals have not increased as rapidly as plating operations. The removal rate has declined markedly during the last decade. Nowadays, approximately 11% of distal radius plates are removed.

Duration of sick leave after operated and non-operated distal radial fracture: a Finnish cohort study of 19,995 patients

“…The overall number of operations performed as ‘Internal fixation of fracture of forearm using plate’ (NCSP, Nordic Classification of Surgical Procedures, code NCJ62) in Finland increased by 6.4% annually between 2012 and 2021 (data extracted from the Finnish National Hospital Discharge Register, HILMO on 6 January 2023). Operative treatment is associated with complications and these patients might be subject to additional operations, such as hardware removal, which can lead to additional sick leave days ( Palola et al., 2021 ).…”

“…However, the incidence of operative treatment is increasing ( Mattila et al., 2011 ; Mellstrand-Navarro et al., 2014 ). The surgical treatment of DRF has shifted towards treatment with open reduction and internal fixation, owing to the rapid and major development of anterior locking plates in the 1990 s, and the number of fixations with K-wires and external fixations have decreased during the same period in the Nordic countries ( Hevonkorpi et al., 2018 ; Palola et al., 2021 ). Operative treatment has been shown to have advantages and seems to result in better functional results in the short term ( Linnanmäki et al., 2023 ).…”

Complications of operatively treated distal radial fractures

“…Removal of plates following distal radial fracture fixation occurs in 3–18% of patients and is more common in younger age groups (18–47 years) (Palola et al., 2021). Mean time after surgery for plate removal was 367 days (Palola et al., 2021).…”

“…Removal of plates following distal radial fracture fixation occurs in 3–18% of patients and is more common in younger age groups (18–47 years) (Palola et al., 2021). Mean time after surgery for plate removal was 367 days (Palola et al., 2021). Most common reasons for hardware removal were tenosynovitis, tendon rupture, pain and prominent hardware or presence of intra-articular hardware (Gyuricza et al., 2011).…”

Functional outcomes following fixation of a marginal distal radius fracture with two commonly used volar locking plates: a retrospective cohort study

“…With advanced implant design, surgical technique, and early post-operation rehabilitation, the functional outcome has improved in recent years. The incidence of implant removal rate has decreased from 20% in 1998 to 12% in 2016 [ 8 , 20 ]. However, not all VLP designs are suitable for marginal distal radius fracture patterns in which fracture line very close to the joint line.…”