Radiographic Analysis in Extra-Articular and Intra-Articular Distal Radius Fractures Treated with Variable-Angle Volar Locking Plate Fixation

Abstract

(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.

Predictive factors of distal radioulnar joint instability after surgical treatment of distal radius fractures

“…Distal radius fractures (RDFs) account for approximately 1/6 of all fractures in the body and are the most common upper extremity fractures [1,2]. For fractures of type B and C in the AO classi cation of RDFs, internal xation with a volar locking plate (VLP) is the most common treatment modality to restore the atness of their articular surfaces [3,4]. Especially for young adults aged 18-65 years with high functional requirements of the wrist joint, surgical treatment can better achieve anatomical repositioning.…”

Predictive factors of distal radioulnar joint instability after surgical treatment of distal radius fractures

“…[ 1 , 2 ] For fractures of type B and C in the AO classification of DRFs, internal fixation with a volar locking plate (VLP) is the most common treatment modality to restore the flatness of their articular surfaces. [ 3 , 4 ] Especially for young adults aged 18 to 65 years with high functional requirements of the wrist joint, surgical treatment can better achieve anatomical repositioning. The incidence of distal radial ulnar joint (DRUJ) instability after DRFs range from 2% to 37% and is a fundamental cause of ulnar wrist pain and can severely limit the rotation of the radius at the distal ulna.…”