Complications of Distal Radius Fractures Treated by Volar Locking Plate Fixation.

The current study investigated the incidence of complications after surgery for distal radial fractures. This multicenter retrospective study was conducted at 11 institutions. A total of 824 patients who had distal radius fractures that were treated surgically between January 2010 and August 2012 were identified. The study patients were older than 18 years and were observed for at least 12 weeks after surgery for distal radius fractures with a volar locking plate. Sex, age, fracture type according to AO classification, implants, wrist range of motion, grip strength, fracture consolidation rate, and complications were studied. Analysis included 694 patients, including 529 women and 165 men, with a mean age of 64 years. The mean follow-up period was 27 weeks. The fracture consolidation rate was 100%. There were 52 complications (7.5%), including 18 cases of carpal tunnel syndrome, 12 cases of peripheral nerve palsy, 8 cases of trigger digit, 4 cases of tendon rupture (none of the flexor pollicis longus), and 10 others. There was no rupture of the flexor pollicis longus tendon because careful attention was paid to the relationship between the implant and the tendon. Peripheral nerve palsy may have been caused by intraoperative traction in 7 cases, temporary fixation by percutaneous Kirschner wires in 3 cases, and axillary nerve block in 1 case; 1 case appeared to be idiopathic. Tendon ruptures were mainly caused by mechanical stress. [Orthopedics.2016; 39(5):e893-e896.].

[1]  H. Drobetz,et al.  Osteosynthesis of distal radial fractures with a volar locking screw plate system , 2002, International Orthopaedics.

[2]  A. Touhami,et al.  Current concepts in volar fixed-angle fixation of unstable distal radius fractures. , 2006, Clinical orthopaedics and related research.

[3]  Masatoshi Takahara,et al.  The short-term reliability of grip strength measurement and the effects of posture and grip span. , 2005, The Journal of hand surgery.

[4]  Gainor Bj,et al.  Extensor tendon rupture secondary to the AO/ASIF titanium distal radius plate without associated plate failure: a case report. , 2000 .

[5]  J. Orbay,et al.  Volar fixation for dorsally displaced fractures of the distal radius: a preliminary report. , 2002, The Journal of hand surgery.

[6]  S. Joseph,et al.  The dorsal horizon view: detecting screw protrusion at the distal radius. , 2011, The Journal of hand surgery.

[7]  H. D. Stewart,et al.  The Hand Complications of Colles' Fractures , 1985, Journal of hand surgery.

[8]  G. S. Phalen,et al.  The carpal-tunnel syndrome. Seventeen years' experience in diagnosis and treatment of six hundred fifty-four hands. , 1966, The Journal of bone and joint surgery. American volume.

[9]  S. Asadollahi,et al.  Flexor tendon injuries following plate fixation of distal radius fractures: a systematic review of the literature , 2013, Journal of Orthopaedics and Traumatology.

[10]  M. Al-Rashid,et al.  Delayed ruptures of the extensor tendon secondary to the use of volar locking compression plates for distal radial fractures. , 2006, The Journal of bone and joint surgery. British volume.

[11]  J. Katarincic,et al.  Fracture of the distal radius: risk factors for complications after locked volar plate fixation. , 2011, The Journal of hand surgery.

[12]  L. Hove,et al.  Fractures of the distal radius in a Norwegian city. , 1995, Scandinavian journal of plastic and reconstructive surgery and hand surgery.

[13]  R. Wollstein,et al.  Rupture of flexor pollicis longus tendon: A COMPLICATION OF VOLAR PLATING OF THE DISTAL RADIUS , 1998 .

[14]  W. Grechenig,et al.  Morphometric analysis of lister's tubercle and its consequences on volar plate fixation of distal radius fractures. , 2008, The Journal of hand surgery.

[15]  M. Tyllianakis,et al.  Long-term results of dorsally displaced distal radius fractures treated with the pi-plate: is hardware removal necessary? , 2011, Orthopedics.

[16]  D. Brown,et al.  Flexor Pollicis Longus Tendon Ruptures after Palmar Plate Fixation of Fractures of the Distal Radius , 2009, The Journal of hand surgery, European volume.

[17]  D. Ring,et al.  Operative Treatment of Volar Intra-Articular Fractures of the Distal End of the Radius* , 1996, The Journal of bone and joint surgery. American volume.