gms | German Medical Science

Objectives/Interrogation: Distal radius fractures are 18% of all orthopedic fractures in adults. Besides their high frequency, they also have a wide range of age distribution and they can be the result of both high and low energy injuries. The best method of treating these kinds of fractures is still debatable. However, locked volar plating is widely used with good reported results

Methods: During the years 2015 and 2018, 83 patients (54 female and 29 male) were operated in our clinic. Their mean age was 51,3 years old. According to AO classification their fractures varied from type A2 to C3. In the majority of cases, closed reduction had been tried and was deemed unsuccessful, so we moved on to a surgical approach, using various volar locking plating systems. All the patients were operated by the same surgeon and were followed up from 6 to 24 months

Results and Conclusions: Patients were clinically examined (flexion - extension of the wrist, ROM of the wrist, grip strength, key - pinch strength) followed by radiographic check at 1, 3,6,12 and 24 months. There were no cases of wound infection. 4 patients were reoperated because they were under 40 years old and in these cases we routinely remove hardware one year after the operation. One patient suffered from FPL injury and was reoperated 2 years after the first operation. In order to discriminate between satisfied and dissatisfied patients, we used the Michigan Hand Outcome Questionnaire, Patient-Rated Wrist Evaluation and also DASH score. We observed that the patients felt more satisfied only when they gained back more than 85% of the ROM of their wrist. It is also worth mentioning the fact that patients, during their rehabilitation, sought to restore more of their grip strength than to improve their key-pinch strength.

Distal radius fractures are peculiar type of fractures. Locked volar plating has very good results when assessed by an experienced and skilled surgeon. Patient's satisfaction is a complex idea and incorporates the success of the operation because it reflects the impact of the functional outcomes to the patient's everyday life. However the relationship between patient's satisfaction and clinical measures of hand outcome has yet to be established.