Journal List > J Korean Orthop Assoc > v.46(5) > 1013097

Kim and Rhee: The Results of Unstable Distal Radius Fracture Following Volar Locking Plate Fixation in Elderly Patients

Abstract

Purpose

The purposes of this prospective study were to find out whether the reduction is maintained 1 year after the volar locking plate fixation of unstable distal radius fracture in elderly patients, and to evaluate the effect of the patient's age and bone mineral density (BMD) on the maintenance of radiographic reduction.

Materials and Methods

Thirty-eight patients aged 65 years or older, with an unstable distal radius fracture were treated by open reduction and internal fixation with the volar locking plate system. Plain radiographs of the wrist, obtained immediately after surgery, were compared with those taken 1 year postoperatively. The evaluated radiographic parameters included radial inclination, volar tilt, ulnar variance and step off. The authors also evaluated correlations between patient factors of age and BMD and the postoperative changes of the four radiographic parameters.

Results

Initial surgical reduction of unstable distal radius fractures was maintained in all 38 patients for 1 year after surgery. No significant correlation was found between patient factors of age, and BMD and the postoperative changes of radiographic parameters during the first year after surgery.

Conclusion

Using volar locking plate for initial reduction was maintained until bony union in elderly patients and showed satisfactory outcome. Also, there was no correlation found in between postoperative changes of radiographic parameters, and the age of patients and BMD until the final bony union.

Figures and Tables

Figure 1
(A) Anteroposterior and lateral radiographs of wrist in a 70-year-old female (AO C2 type fracture). (B) Postoperative anteroposterior and lateral radiographs. (C) Postoperative 1 year anteroposterior and lateral radiographs.
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Table 1
Results according to the Radiographic Evaluation
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Table 2
Correlation between Patient Age, and Changes in the Four Radiographic Parameters over the 1st Postoperative Year
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Table 3
Correlation between Patient BMD and Changes in the Four Radiographic Parameters over the 1st Postoperative Year
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Table 4
The Wrist Functional Outcomes at Each Visit
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DASH, disability of arm, shoulder, and hand; MMWS, modified Mayo wrist score; VAS, visual analogue pain scale.

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