Dual Plating Technique for Volar Rim Fracture of the Distal Radius Using DePuy-Synthes 2.0 m and 2.4 mm Locking Plates.

ABSTRACT

BACKGROUND: To assess the surgical results of distal radius fractures with the involvement of a volar rim fragment using the DePuy-Synthes 2.0 mm and 2.4 mm locking plates. METHODS: Subjects were six women and one man of average age 57 years (range, 31-83 y) and a mean follow-up period of 9 months (range, 5-19 mo) with AO B3 (volar shearing) distal radius fractures. Time of the procedure, physical examination of wrist range of motion, grip strength compared with the contralateral healthy wrist, and radiographic evaluation (volar tilt, radial inclination, and ulnar variance) were evaluated. The Visual Analog Scale (VAS 0 points represents no pain, 100 points represents the worst pain possible) and the Quick Disability of the Arm, Shoulder, and Hand questionnaire (QuickDASH, 0 = no disability, 100 = extreme disability) were completed by patients at the final follow-up. RESULTS: The average time of the procedure was 74 min. There were no perioperative complications. Average radiographic measures were volar tilt, 8°; radial inclination, 23°, and ulnar variance, 0 mm. Wrist range of motion averaged 63° in wrist extension (range, 55-80°) and 55° in wrist flexion (range, 45-65°). Grip strength averaged 81% of the contralateral side at final evaluation (range, 67-100%). The mean QuickDASH score was 3.0 points (range, 0-9.1 points) and the mean VAS for pain was 9.3 at final follow-up. CONCLUSIONS: Open reduction internal fixation with the DePuy-Synthes 2.0 mm and 2.4 mm locking plates is an effective means of fixing a distal radius fracture that includes a volar rim fragment without interfering with flexor tendon gliding.