Prospective study of comminuted articular distal radius fractures stabilized by volar plating in the elderly
- 162 Downloads
The objective was to assess the ability of the volar locking plate to maintain the radiographic parameters over the time in elderly patients with complex intra-articular distal radius fractures.
Prospective cohort of 66 consecutive patients with mean age of 68 (range 60–81) years and AO type C fractures treated with volar locking plate. Radiographic measurements were performed pre and post-operatively at each follow-up. Clinical assessment was made by Patient-Rated Wrist Evaluation scores, Disabilities of the Arm, Shoulder and Hand score, range of motion, and grip strength.
The mean post-operative follow-up was 31 (range, 24–47) months. The most difficult parameters to restore intra-operatively were volar tilt and radial height, while radial inclination and ulnar variance were restored in a high rate of patients. There was significant loss of reduction within four post-operative months in volar tilt (p = 0.001) and radial height (p = 0.029). Mean radiographic parameters had no changes from four months to final evaluation. At final follow-up, 50.1% of the patients had all radiographic parameters restored in comparison with the noninvolved wrist, but 83.3% had all radiographic parameters within a functional range (p = 0.001). No significant relationship between radiographic and functional outcomes was found (p = 0.474).
This study found that volar locking plate fixation for displaced intra-articular distal radius fractures in elderly patients was an effective procedure to obtain success functional outcomes. Although reduction loss in volar tilt and radial height occurred within four first months, volar plate was able to maintain fracture stabilization with radiographic parameters within functional range over the time in most patients of these elderly patients.
KeywordsDistal radius fracture Intra-articular fracture Elderly Surgical treatment Volar locking plate Radiographic outcome
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 23.Arora R, Gabl M, Gschwentner M, Deml C, Krappinger D, Lutz M (2009) A comparative study of clinical and radiologic outcomes of unstable colles type distal radius fractures in patients older than 70 years: nonoperative treatment versus volar locking plating. J Orthop Trauma 23:237–242. https://doi.org/10.1097/BOT.0b013e31819b24e9 CrossRefPubMedGoogle Scholar
- 27.Ruckenstuhl P, Bernhardt GA, Sadoghi P, Glehr M, Holzer LA, Leithner A, Wolf M, Gruber G (2014) Quality of life after volar locked plating: a 10-year follow-up study of patients with intra-articular distal radius fractures. BMC Musculoskelet Disord 15:250. https://doi.org/10.1186/1471-2474-15-250 CrossRefPubMedPubMedCentralGoogle Scholar