Results of surgical treatment of unstable distal radius fractures with articular involvement in adults

Purpose: To evaluate the results of the surgical treatment of distal radius fractures with anatomical plate by volar approach. Material Method: In our study fourty-one patients ,who followed-up for average 27 (13-82) months, with distal radius fracture had retrospectively evaluated that operated by volar plate between the years 2006 to 2013. Frykman and AO classifications were used. According to the Frykman classification 12 fractures were type 8 (29,3%), 8 fractures were type 4 (19,5), 7 fractures were type 2 (17,1%), 5 fractures type 7 (12,2%), 5 fractures were type 1 (12,2%), 3 fractures were type 3 (7,3%), 1 fracture was type 5 (2,4%). According to the AO classification 13 fractures were type C3 (31,7%), 7 fractures were type A3 (17,1), 7 fractures were type B3 (17,1%), 5 fractures type B1 (12,2%), 3 fractures were type C1 (7,3%), 3 fractures were type C2 (7,3%), 2 fractures were typeA2 (4,9%), 1 fracture was type B2 (2,4%). Gartland-Werley scoring system was used by dynamometer and goniometer. DASH and Stewart radiological scale was used. Result: According to Gartland and Werley criterias 25 patients (61%) were excellent, 9 patients (22%) were good, 6 patients (14,6%) were fair, 1 patient (2,4%) was poor. There was no statistically significantly difference between the operated side and the normal side according to the range of motion, grip strength and clinical assessments. According to Stevart radiological criterias 11 patients (26,8%) were excellent, 28 patients (68,3%) were good, 1 patient (2,4%) was fair, 1 patient (2,4%) was poor. There was no statistically difference between the operated side and the normal side. Conclusion: In this study, we used the volar radial plates, particularly in the treatment of distal radius problematic unstable intra-articular fractures and successful results were obtained. We reported that it is an effective method for anatomical reduction and stabil fixation. This method allows early wrist rehabilitation. Volar approach is an effective method for radius distal fractures because of achieving a more harmonius with the surrounding tissues. The complications are low. It has relationship with learning curve. Keywords: Distal radius fractures, Locked anatomical plate, Unlocked plate, İnternal fixation