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· DOS Abstracts
Volar locking plate surgery fails to restore the anat-
omy after distal radius fracture
Mette Lund Madsen, Daniel Wæver, Jan Duedal Rölfing, Lars Carl Borris, Lise Loft
Nagel, Mads Henriksen, Rikke Thorninger
Ortopædkirurgisk afdeling, Regionshospital Randers; Ortopædkirurgisk afdeling,
Regionshospital Randers; Ortopædkirurgisk afdeling, Aarhus Universitetshospi-
tal; Ortopædkirurgisk afdeling, Aarhus Universitetshospital; Røntgen og Skan-
ning, Aarhus Universitetshospital; Røntgen og Skanning, Aarhus Universitet-
shospital; Ortopædkirurgisk afdeling, Aarhus Universitetshospital
Background:
Recent studies question the clinical advantage and cost effec-
tiveness of volar locking plates. Here, we investigate whether volar plating can
restore the anatomy after distal radius fracture.
Purpose / Aim of Study:
The purpose of the study was to determine the
radiologic outcome after volar plating of distal radius fractures. Our hypothesis
was that volar locking plate surgery restores the anatomic angulation and length
of the radius.
Materials and Methods:
576 patients (median age 63, 78% women) were
treated with 2 different volar locking plates (VariAx and Acu-Loc) over a period
of 3.2 years by 64 surgeons. Three independent observers evaluated angula-
tion and ulnar variance (>2mm) on the latest radiographs before surgery and
postoperatively at 0 and 5 weeks.
Findings / Results:
The mean angulation was -18.0 ±5.4 and 15.5 ±11.2 de-
grees for volarly and dorsally displaced fractures, respectively. After surgery,
there was no statistically significant difference between volarly and dorsally dis-
placed fractures and the type of plates. Immediately after surgery the mean
angulation was -4.5 ±6.3 degrees. After 5 weeks the mean angulation of -3.9
±7.0 degrees did not statistically differ from the immediately postoperative
measurements, p=0.79. Thus, the anatomic angulation of -12 degrees was not
achieved (p<0.001). The mean differences between the three independent ob-
servers were minor, ranging from 0.3-1.8 degrees at the different time points
(p<0.05). Shortening of the radius (>+2mm ulnar variance) was still present in
13% (95%CI 10-16) after surgery.
Conclusions:
Contrary to common perception, volar locking plate surgery did
not restore normal anatomy in terms of volar angulation and radial length. The
clinical implication is unclear, because functional outcome was not available.
No conflicts of interest reported
160.