[Clinical effects of locking plate system in treating distal radial fractures]

Ziguang Zhou, Kenny Kwan, T W Law, Frankie K L Leung
Chinese Journal of Reparative and Reconstructive Surgery 2009, 23 (11): 1294-7

OBJECTIVE: To determine the clinical results of locking plate system in the treatment of distal radial fractures.

METHODS: From May 2004 to November 2006, 75 patients were treated with 2.4 mm locking plate system. There were 41 males and 34 females, with a mean age of 51 years old (range, 13-82 years old). The locations were left side in 34 cases and right side in 41 cases. The cause of injury was a low energy fall in 49 cases, falling from height in 14 cases, traffic accident in 6 cases and sports injuries in 6 cases. All patients were diagnosed as having closed fracture. According to Müller-AO classification, there were 14 cases(18.7%) of type A, 5 cases(6.7%) of type B, and 56 cases(74.6%) of type C. The time from injury to operation was 5 hours to 27 days (mean 6 days).

RESULTS: A total of 75 patients were followed up at 3 months, 71 patients at 6 months, 68 patients at 1 year and 51 patients at 2 years. Healing by first intention of incision was achieved in 73 cases, and infection occurred in 2 cases. Fracture reduction failed at 1 month, 3 months and 6 months in 1 case, respectively; 1 case received plaster fixation and 2 cases received re-fixation and autograft of ilium; and fracture healed in 3 cases at last follow-up. Two patients complained of skin numbness at site of superficial branch of radial nerve after 1 day, 1 patient had wound pain after operation, and 1 patient had infection of tendon at 3 days and 5 days in 1 case respectively. At last follow-up, the ranges of motion of wrist joint were (80 +/- 9) degrees for pronation, (86 +/- 7) degrees for supination, (57 +/- 10) degrees for dorsal flexion, (51 +/- 13) degrees for palmar flexion, (18 +/- 7) degrees for radial inclination, and (28 +/- 7) degrees for ulnar deviation. According to modified Green scoring, the results were excellent in 66 cases, good in 6 cases and poor in 3 cases. At last follow-up, according to Knirk criterion for osteoarthritis, there were 22 cases of grade I and 5 cases of grade II, and all were classified as type C.

CONCLUSION: Internal fixation of distal radial fractures with 2.4 mm locking plate system provided a stable fixation with good clinical outcomes.

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