Журнал травм и лечения

Complications and Plate Removal Surgeries after Performing Volar Plating of Unstable Distal Radius Fractures

Abstract

John H. Williksen, Torstein Husby, Hebe D. Kvernmo and Frede Frihagen

Purpose: To determine the number of complications and plate removal surgeries after performing volar locking plate fixation of unstable distal radius fractures. Methods: In 2008, there were 100 patients (101 unstable fractures of the distal radius) who were treated with volar locking plates at our hospital. Thirteen patients were lost to follow-up; thus, 87 patients with 88 fractures were reviewed (65 women and 22 men). The mean age was 51 years (range, 17-86 years). In 2010, all the patients were clinically and radiologically assessed. In 2014, the number of hardware removals and complications was retrospectively assessed based on patient records. There were 9 A2, 14 A3, 6 B1, 1 B2, 11 B3, 29 C1, and 18 C2 fractures, according to the AO/ OTA classification. The complications, plate removal surgeries, and clinical and radiological outcomes were recorded. In 2010 the patients were clinically assessed using the visual analog scale (0–100 points) pain score at rest and at activity, Mayo Wrist Score (0–100 points), Quick-Disabilities of the Arm, Shoulder, and Hand (0–100 points), and range of motion. Plain radiographs of the wrist were also obtained. Results: Twenty-nine patients had complications (33%), which led to worse clinical results during the follow-up in 2010. Until 2014, hardware removal had been performed in 17 (19%) patients, and this was beneficial in 62%. The main reasons for plate removal were extensor tendon synovitis and pain, and screw penetration into the radiocarpal joint. Conclusion: The use of volar locking plates in unstable distal radius fractures is associated with several surgicalrelated complications, which has to be considered when using this method. Information about the complications may alter the patient outcomes more positively.