Fixation of distal radius AO type c fractures with a volar locking plate: Radiographic and clinical investigation

Aim: In this study, we aimed to investigate the effect and compatibility of Batra radiographic score and radiologic values on clinical scores and functional outcomes after volar plate fixation of unstable AO type C distal radius fractures in adults. Patients and Methods: Between January 2017 and June 2023, patients who underwent surgery with volar plating for adult distal radius AO type C fractures were analyzed restrospectively. All patients were evaluated radiologically and etiologically, and a comparative radiologic and functional analysis was performed in 108 patients with distal end articular fractures of the radius who underwent open reduction plate screw osteosynthesis Fracture classification of all patients was performed according to the AO classification The Batra radiologic-anatomic classification was used for radiologic score evaluation and the DASH score, Gartland-Werley scoring system, Modified Mayo scoring system and Modified Green and O'Brien scoring system were used for the evaluation of wrist functional outcomes. Results: The mean age of the 108 patients included in the study was 48 years. The minimum age of the patients was 22 years and the maximum age was 83 years. It was determined that 82.4% of the fractures were caused by simple falls, 10.2% by traffic accidents and 7.4% by falls from a height. In 14 (12.9%) patients, the distal end fracture of the radius was associated with an additional fracture in the same extremity and/or elsewhere in the body. According to the AO classification, 43 (39.8%) patients were C 1, 45 (41.7%) were C 2 and 20 (18.5%) were type C 3. The radiological anatomical Batra score of the patients was excellent in 16(14.8%), good in 37(34.3%), fair in 32(29.6%) and poor in 16(14.8%). According to the Modified Mayo scoring of the patients, the mean score was 77.0± 11.0, the minimum and maximum was 50.0 - 95.0 and the median value was 80.0. It was evaluated that 18 (16.7%) patients were classified as excellent, 42 (38.9%) as good, 35 (32.4%) as fair and 13 (12%) as poor. The mean Modified Green and O'Brien classification score was 78.1± 11.5 with a minimum and maximum of 45.0-95.0 and a median of 80.0. According to the Green and O'Brien classification score, 20(18.5%) of the patients were evaluated as excellent, 40(37.0%) as good, 32(29.6%) as fair and 16(14.8%) as poor. When the Modified Gartland and Werley Scores of the patients were evaluated; the mean was 8.7 ± 6.0, the minimum and maximum were 1.0 - 23.0 and the median was 7.0. Of the patients, 19 (17.6%) were excellent, 40 (37.0%) were good, 42 (38.9%) were fair and 7 (6.5%) were poor. The mean DASH score on the fractured side was 14.4 ± 17.1 and the mean DASH score on the uninjured side was 0.8 ± 1.3. Conclusion: In our study, fixation with a locking volar plate was found to be extremely good on clinical and functional results. With the correction of radiologic criteria, patients can start functional movement early and return to work and life early. In our study, the clinical results of 108 AO type C distal end fractures of the radius after plate screw osteosynthesis and the compatibility of the radiologic score with the clinical scores showed that the Modified Mayo and Modified Green and O'Brien clinical scores were more compatible with the radiologic scores.