VOLAR LOCKING PLATE OSTEOSYNTHESIS IN DISTAL END RADIUS FRACTURES

Abstract

Gyan Ranjan, Indranil Dutt, Abhishek Jain, Tulika Singh, Barunesh Kishore, Saurabh Kumar, Pankaj Kumar Singh,Abhinav Mishra

BACKGROUND
Distal end Radius fractures account for about 20% of all the fracture treated in emergency department of Kosi & Seemanhcal area in Bihar. The majority of osteoporotic fractures occur as a result of fall from standing height on outstretched hand while in young patients, distal end radius fractures are seen secondary to RTA & sports activities. We conducted a study of a small group to evaluate the functional outcome of ORIF & volar locking plate fixation done for distal end radius fractures after one year.
MATERIALS AND METHODS
Records of 19 men and 41 women aged 17 to 78 years who underwent volar locking plate fixation for distal radial fractures were reviewed. According to AO-Classification of Distal End Radius fractures. 2 Patients had A2 Type of fracture, 3 had A3 Type, both B2 & B3 had 4 cases each, 15 of C1 Type, 21 of C2 type and 11 0f C3 Type. Functional outcome was assessed by using “Demerit point rating system” of Gartland & Werley. In all the patients at their final follow-up visit at 12 months.
RESULTS
Out of all these 60 patients, 9 cases had 10 complications, 2 cases developed Grade (I) Arthritis, 2 cases developed Grade (II) arthritis, 1 case developed superficial skin infection with medium nerve compression symptoms, 2 cases developed superficial skin infection which was resolved by continuous dressing on alternate days & 5 cases developed median nerve compression symptoms in which for 2 cases symptoms resolved with time, in rest 3 cases carpal Tunnel Decompression was done. Overall 63.3% result were excellent, 23.3% were good & 13.3% fair outcomes. The residual deformity was 0.70 the subjective score was 1.47 the objective score was 1.70, the total demerit score was as per modification Garland & Werley scoring groups (Mean values was 3.67). In all the cases, stainless steel plate was used.
CONCLUSION
In distal end radius fractures open reduction and internal fixation with volar locking compression plate followed by early rehabilitation gives good functional outcome and less complications. Hence it is considered to be one of the treatment of choice in distal end radius fractures.

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