Volar Plating for Displaced Fractures of the Distal Radius

Purpose: The aim of this project was to study the functional outcome of displaced distal radius fractures treated with the use of a locking volar plate. Methods: Twenty-five consecutive patients with displaced distal radius fractures were treated with open reduction and internal fixation, using the volar locking AO plate. Bone grafting was used in 9 cases. Postoperative evaluation included radiographic assessment and range of motion of the affected wrists. Controlled passive and active motion exercises were initiated on the seventh postoperative day. Functional outcomes were evaluated with use of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and the Gartland and Werley scoring system. Results: The mean follow-up was 18 months. There was no failure of fixation or loss of the reduction. Thirteen of fifteen patients with intra-articular fractures had good or excellent results, while 9 of 10 patients with extra-articular fractures had excellent results. The mean score on the DASH questionnaire was 14 points. Ranges of motion in intra-articular fractures were measured as 58° for wrist extension, 70° for flexion, 70° for pronation and 65° for supination, while for extra-articular fractures they were 75° extension, 78° flexion, 82° pronation and 78° supination. Conclusions: Treatment of distal radius fractures through a volar approach using the AO volar plate appears to be effective. This technique restores the anatomy of the distal radius predictably, allowing a safe and early range of motion.