Prospective study of distal radius fractures treated with a volar locking plate system.

PURPOSE: To prospectively determine the results of treatment of distal radius fractures with a volar locking plate system with no bone graft and early mobilization.

METHODS

Internal fixation and early mobilization of dorsally displaced, unstable fractures of the distal radius using a volar locking plate system without bone grafting was investigated in a prospective series of 49 fractures in 49 consecutive patients. All patients were allowed to move the wrist joint immediately after surgery. Physical examination at 5 weeks, 3 months, 6 months, and 1 year after the operation were performed. Radiographic parameters on preoperative, postoperative, and 1-year postoperative radiographs were compared. At 1-year review, the final clinical functions were evaluated with the Gartland and Werley functional scoring system, a modified Green and O'Brien system, and the Disabilities of the Arm, Shoulder, and Hand questionnaire.

RESULTS

The average radiographic results at 1 year were 9 degrees of volar tilt; 22 degrees of radial inclination; 1 mm of ulnar variance, and 0 mm of articular incongruity. At 1-year review, an excellent or good result was found according to the system of Gartland and Werley and a modified Green and O'Brien system with scores of 100% and 98%, respectively. The Disabilities of the Arm, Shoulder, and Hand score averaged 6, indicating a high degree of patient satisfaction. There were no cases of infection, complex regional pain syndrome, tendon rupture, tendon irritation, nerve injury, or implant failure.

CONCLUSIONS

The volar locking plate fixation without bone grafting and early mobilization is a safe and effective treatment for dorsally displaced, unstable fractures of the distal radius.