Polyaxial Locking Plate in Fractures of the Distal Radius

Introduction: Volar locking plate represents the gold standard method of treatment of unstable distal end radius fractures.

Objectives: The Present study aimed to identify the functional and radiological outcomes of distal radius fractures treated by open reduction and internal fixation using polyaxial volar locking plate.

Patients and Methods: We reviewed 25 unstable distal end radius fractures that were operated in Orthopedic Department in Tanta University Hospital with polyaxial volar locking plates June 2018 to June 2019. The mean age of the patients was 40.8±14.34 years (range 24 to 65) and the mean duration of follow-up was 8.61 ± 3.19 months (range 6 to 17). All of the patients underwent open reduction and internal fixation with polyaxial locking plate through over flexor carpi radialis approach. After three months, pain, tendon functions, ROM, hand grip as well as radial median and ulnar nerves functions were well assessed. X-rays were done to assure full fracture consolidation. At the end of follow up, clinical results were evaluated according to Quick DASH Score. Castaign radiological assessment score was used for radiological evaluation.

Results: There was a significant improvement in the functional indices from twelve weeks to the final follow-up. According to Castaign radiological assessment score 10 patients (40%) had excellent results, 14 patients (56%) had good results and 1 patient (4%) had fair results, no patients had poor results at the final follow up. Compared the performance of the polyaxial locking plate to another monoaxial plate and reported an improved range of radial and ulnar deviation with the variable angle device but they use another plate system.

Conclusions: The use of polyaxial locking plates in treating unstable distal end radius fractures is associated with excellent to good functional results with minimal complications.