Table of Contents
ISRN Orthopedics
Volume 2013 (2013), Article ID 131757, 6 pages
http://dx.doi.org/10.1155/2013/131757
Clinical Study

Dorsally Comminuted Fractures of the Distal End of the Radius: Osteosynthesis with Volar Fixed Angle Locking Plates

1Department of Orthopaedics and Rehabilitation, Pt. B.D. Sharma Post graduate Institute of Medical Sciences, 2/11-J Medical Enclave, PGIMS, Haryana, Rohtak 124001, India
2Department of Orthopaedics, Dayanand Medical College and Hospital, Punjab, Ludhiana 141001, India

Received 12 March 2013; Accepted 14 April 2013

Academic Editors: D. H. Clements, C.-H. Lee, G. Papachristou, C.-H. Tsai, and B. K. Weiner

Copyright © 2013 Paritosh Gogna et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Dorsally comminuted distal radius fractures are unstable fractures and represent a treatment challenge. The objective of this study was to evaluate the functional and radiological outcome of dorsally comminuted fractures of the distal radius fixed with a volar locking plate. Patients and Methods. Thirty-three consecutive patients with dorsally comminuted fractures of the distal end of the radius were treated by open reduction and internal fixation with AO 2.4 mm ( )/3.5 mm ( ) volar locking distal radius plate (Synthes, Switzerland, marketed by Synthes India Pvt. Ltd.). There were 7 type A3, 8 type C2, and 18 type C3 fractures. The patients were followed up at 6 weeks, 3 months, 6 months, and 1 year postoperatively. Subjective assessment was done as per Disabilities Arm, Shoulder, and Hand (DASH) questionnaire. Functional evaluation was done by measuring grip strength and range of motion around the wrist; the radiological determinants were radial angle, radial length, volar angle, and ulnar variance. The final assessment was done as per Demerit point system of Saito. Results. There were 23 males and 10 females with an average age of 44.12 ± 18.63 years (18–61 years). Clinicoradiological consolidation of the fracture was observed in all cases at a mean of 9.6 weeks (range 7–12 weeks). The average final extension was 58.15° ± 7.83°, flexion was 54.62° ± 11.23°, supination was 84.23° ± 6.02°, and pronation was 80.92° ± 5.54°. Demerit point system of Saito yielded excellent results in 79% ( ), good in 18% ( ), and fair in 3% ( ) patients. Three patients had loss of reduction but none of the patients had tendon irritation or ruptures, implant failure, or nonunion at the end of an one-year followup. Conclusion. Volar locking plate fixation for dorsally comminuted distal radius fractures results in good to excellent functional outcomes despite a high incidence of loss of reduction and fracture collapse.