Clinical, functional and radiological outcomes of the use of fixed angle volar locking plates in corrective distal radius osteotomy for fracture malunion

Main Article Content

Valerio Pace
Pasquale Sessa
Matteo Guzzini
Marco Spoliti
Alessandro Carcangiu
Natale Criseo
Alessandro Giai Via
Luigi Meccariello
Auro Caraffa
Riccardo Maria Lanzetti

Keywords

Distal radius fractures, distal radius mal-union, corrective osteotomy, fixed-angle locking volar plate, hand rehabilitation

Abstract

Background and aim: Fractures of the distal radius are a common injury and mal-union can occur in those managed non-operatively. This can cause significant functional limitations along with pain. A corrective osteotomy with the use of a volar locking plate aims to restore articular surface congruency and improve outcomes. We present our local experience with clinical, functional and radiological outcomes of corrective osteotomy using a fixed angle volar locking plate and bone graft for management of distal radius mal-union.


Methods: Retrospective study. All adult patients. Both pre and post operatively clinical range of motion was recorded. Post operative PROMS was measure by DASH, MAYO and SF-12 and pain by means of a VAS measured from 0-10. Mean follow up period was at 15 months.


Results: 32 patients underwent the studied procedure. 24F-8F. Mean age: 56. Radiological union of corrective osteotomy: 28 (88%) of patients. 4 patients required further operative treatment to achieve corrective union. No other reported complications post-op. Post-operatively flexion improved by 24 and extension 20. Pronation was improved by 24 and supination 22. Pain was improved from an average VAS pre-operative of 5.6 to 1.6 post-operatively. Mean DASH scored improved from 57.8 to 16.2 post-operatively and MAYO 38.5 to 58.6. The mean post-operative SF-12 score was 46.2 from 31.


Conclusions: In this series of 32 patients (the biggest reported in the literature in our knowledge) a  corrective osteotomy with fixed-angle volar locking plate for mal-united distal radius has shown to improve both clinical-radiological and patient reported outcomes and provide good results of the very few complications’ treatments.

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