Clinical results of open reduction and internal fixation with volar locking plate in radius distal fractures

The results of the surgical treatment of distal radius fractures with anatomical plate by volar approach evaluated retrospectively from patient outcomes In this study, results of 23 patients with an average follow-up time for 24 months (15-52) and with a mean age of 44.11 (17-73), diagnosed with radius distal fracture and treated surgically with volar locking plate between the dates agust 2013 and agust 2016 in Fırat Univercity Hospital Orthopaedics and Traumatology Clinic, evaluated retrospectively from patient files. 27 (% 64.2) of patient were male and 15 (% 35.8) were famale. 20 (% 47.6) of patient were right radius distal fracture,22 (% 52.4) were lef and all of their dominant side was right. İn this study we used Frykmann and AO Classification. There were 11 type C1 (%26.2), 11 type C2 (%26.2), 9 type B3 (%21.4), 5 type A3 (%11.9), 2 type B1 (%4.8), 2 type B2 (%4.8) and 2 type C3 (%4.8) fractures according to the AO Classification System and the Frykman Classification there were 17 type 7 (%40.5), 11 type 8 (%26.2), 7 type 5 (%16.7), 2 type 6 (%4.8), 2 type 2 (%4.8), 1 type 1 (%2.4), 1 type 3 (%2.4) and 1 type 4 (%2.4) fractures. Stewart's radiological criteria and range of motion were used in clinical and radiological evaluation. QuickDASH-T and Gartland-Werley scores were used for functional assessment. At clinical examination of patients in last follow-up; when wrist and forearm range of joint motions are; the operated side/the firm side flexion; 70,9º/73,6º, the operated side/the firm side extension; 67,3º/71,5º, the operated side/the firm side radial deviation; 27,0º/28,4º, the operated side/the firm side ulnar deviation; 32,8º/35,3º, the operated side/the firm side supination; 77,7º/83,2º, the operated side/the firm side pronation; 82,5º/85,3. Patients' hand grip strengths were measured using a dynamometer (CAMRYelectronic hand dynomometer) and elbow 90 °, while the forearm and wrist were in neutral position. The values were found by taking the percentage according to the firm side. All patients had a mean grip strength of 87.09% (p<0,001). For patients with right distal radius fracture, the mean grip strength was 92.17%. For the patients with right distal radius fracture, 82.76% of patients with a mean grip strength average were found (p<0,001). All group was considered statistically significant. According to Gardland and Werley cilinically evaluation criters; excellent was 16 (% 38,1), good was 22 (% 52,4), moderate was 4 (% 9,5). The radiological measurment in last follow-up in, pre-op/pos-op radial lenght were 8,28/14,04, pre-op/pos-op radial inclinacition were 13,83/21,50, pre-op/pos-op volar tilt were -5,23/8,21. In terms of radiological, functional outcomes and complication rates, our study had similar results with the studies in the literature. In the fractures involving the joint, the absolute fixation and complete reduction were achieved, and there was a kannatine in which the stability and continuity of the fixation was an effective fixation tool for the distal end-locked volar plate. In addition, after the plate fixation, we started to move the joints without immobilization at the earliest time. In the volar attempt, we found that after reaching the fracture, the fracture restored to the soft tissue with minimal damage and provided adequate opening. As a result, volar locking plate applications in the distal radius fractures, careful preoperative planning and appropriate technique, careful surgical approach and controlled rehabilitation are successful methods. Key words: Radius distal end, fractures, volar locked anatomic plate