J Korean Fract Soc.  2008 Jul;21(3):220-224. 10.12671/jkfs.2008.21.3.220.

Volar T-Locking Compression Plate for Treatment of Unstable Distal Radius Fractures

• Cho CH
• Bae KC
• Kwon DH

• KMID: 2015445
• DOI: http://doi.org/10.12671/jkfs.2008.21.3.220

Abstract

PURPOSE: To evaluate outcomes volar T-locking compression plate for treatment of unstable distal radius fractures.
MATERIALS AND METHODS
We retrospectively analysed the results in 35 cases, which were treated by volar plating with T-LCP. We evaluated the clinical results according to the Mayo wrist scoring system and radiographic results.
RESULTS
The mean score was 83.86 respectively. Between preoperative and immediate postoperative radiographic measurements, averaged radial length was improved from 5.75 mm to 11.53 mm, radial inclination from 12.86 degrees to 22.56 degrees, volar tilt from -3.64 degrees to 9.90 degrees and intraarticular step-off from 1.48 mm to 0.42 mm. Between immediate postoperative and latest follow-up radiographic measurements, mean loss of radial length measured 0.43 mm, radial inclination 0.46 degrees, volar tilt 0.89 degrees.
CONCLUSION
Treatment of unstable distal radius fractures using a volar T-LCP showed satisfactory outcomes. We think that it is good surgical option to allow return to daily living, result in early postsurgical wrist motion.

Keyword

Distal radius; Unstable fracture; T-locking compression plate; Volar approach

MeSH Terms

Follow-Up Studies
Radius
Radius Fractures
Retrospective Studies
Wrist

Figure

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  Fig. 1 51-year-old woman with unstable distal radius fracture was treated by open reduction and internal fixation with T-LCP. (A) Preoperative radiographs show AO classification C2 fracture. (B) Immediate postoperative radiographs show successful reduction and fixation. (C) Radiographs at 8 months postoperatively show no significant loss of reduction.

Reference

1. Arora R, Lutz M, Fritz D, Zimmermann R, Oberladstatter J, Gabl M. Palmar locking plate for treatment of unstable dorsal dislocated distal radius fractures. Arch Orthop Trauma Surg. 2005; 125:399–404.

2. Cheon SJ, Ku JK, Lee DH, Kim HT, Suh JT. Treatment of distal radius fractures using the percutaneous K-wire reduction-fixation and external fixation. J Korean Fract Soc. 2006; 19:228–235.

3. Constantine KJ, Clawson MC, Stem PJ. Volar neutralization plate fixation of dorsally displaced distal radius fractures. Orthopedics. 2002; 25:125–128.

4. Cooney WP. External fixation of distal radial fractures. Clin Orthop Relat Res. 1983; 180:44–49.

5. Cooney WP, Bussey R, Dobyns JH, Linscheid RL. Difficult wrist fractures. Perilunate fracture-dislocations of the wrist. Clin Orthop Relat Res. 1987; 214:136–147.

6. Cooney WP 3rd, Dobyns JH, Linscheid RL. Complications of Colles' fractures. J Bone Joint Surg Am. 1980; 62:613–619.

7. Cooney WP 3rd, Linscheid RL, Dobyns JH. External pin fixation for unstable Colles' fractures. J Bone Joint Surg Am. 1979; 61:840–845.

8. Frykman G. Fracture of the distal radius including sequalae shoulder-hand-finger syndrome, disturbance in the distal radioulnar joint and impairment of nerve function. A clinical and experimental study. Acta Orthop Scand. 1967; Suppl 108. 3+.

9. Herron M, Faraj A, Craigen MA. Dorsal plateing for displaced intra-articular fractures of the distal radius. Injury. 2003; 34:497–502.

10. Horesh Z, Volpin G, Hoerer D, Stein H. The surgical treatment of severe comminuted intra-articular fractures of the distal radius with small AO external fixation device. A prospective three-and-one-half-year follow-up study. Clin Orthop Relat Res. 1991; 263:147–153.

11. Huh CY, Yoon JR, Ha HS. Treatment of fractures of the distal radius with external fixator. J Korean Soc Fract. 1999; 12:995–1002.

12. Kamano M, Honda Y, Kazuki K, Yasuda M. Palmar plating for dorsally displaced fractures of the distal radius. Clin Orthop Relat Res. 2002; 397:403–408.

13. Knirk JL, Jupiter JB. Intra-articular fractures of the distal end of the radius in young abults. J Bone Joint Surg Am. 1986; 68:647–659.

14. Koval KJ, Hoehl JJ, Kummer FJ, Simon JA. Distal femoral fixation: a biomechanical comprison of the standard condylar buttress plate, a locking buttress plate and the 95-degree blade plate. J Orthop Trauma. 1997; 11:521–524.

15. Lafontaine M, Hardy D, Delince P. Stability assessment of distal radius fractures. Injury. 1989; 20:208–219.

16. Leung F, Zhu L, Ho H, Lu WW, Chow SP. Palmar plate fixation of AO type C2 fracture of distal radius using a locking compression plate-a biomechanical study in a cadaveric model. J Hand Surg Br. 2003; 28:263–266.

17. Lidstrom A. Fractures of distal end of the radius. A clinical and statistical study of end results. Acta Orthop Scand Suppl. 1959; 41:1–118.

18. Lipton HA, Woollstein R. Operative treatment of intraarticular distal radius fractures. Clin Orthop Relat Res. 1996; 327:110–124.

19. Lucas GL, Sachtjen KM. An analysis of hand function in patients with Colles' fracture treated by Rush rod fixation. Clin Orthop Relat Res. 1981; 155:172–179.

20. Orbay JL. The treatment of unstable distal radius fractures with volar fixation. Hand Surg. 2000; 5:103–112.

21. Park MJ, Ha SH. Treatment of intra-articular fractures of the distal radius using wrist arthroscopy. J Korean Orthop Assoc. 2004; 39:258–264.

22. Ring D, Prommersberger K, Jupiter JB. Combined dorsal and volar plate fixation of complex fractures of the radius. J Bone Joint Surg Am. 2004; 86:1646–1652.

23. Scheck M. Long-term follow-up of treatment of comminuted fractures of the distal end of the radius by transfixation with kirschner wires and cast. J Bone Joint Surg Am. 1962; 44:337–351.

24. Sim JC, Chung NS, Hong KD, Ha SS, Kang JH. Treatment of fractures of the distal radius using locking compression plate. J Korean Fract Soc. 2005; 18:100–104.

25. Trumble TE, Culp RW, Hanel DP, Geissler WB, Berger RA. Intra-articular fractures of the distal aspect of the radius. Instr Course Lect. 1999; 48:465–480.

26. Wright TW, Horodyski M, Smith DW. Functional outcome of unstable distal radius fractures: ORIF with a volar fixed-angle tine plate versus external fixation. J Hand Surg Am. 2005; 30:289–299.

27. Zimmermann R, Gabl M, Lutz M, Angermann P, Gschwentner M, Pechlaner S. Injectable calcium phosphate bone cement Norian SRS for the treatment of intra-articular compression fractures of the distal radius in osteoportic women. Arch Orthop Trauma Surg. 2003; 123:22–27.