Mid-Term Functional Outcome after Volar Locking Plate Fixation of Distal Radius Fractures in Elderly Patients

J Hand Surg Asian Pac Vol. 2018 Jun;23(2):238-242. doi: 10.1142/S2424835518500273.

Abstract

Background: The volar locking plate is frequently used in the fixation of unstable distal radius fractures, but despite this there is a paucity of mid to long term outcome studies. The purpose of this study was to investigate the mid-term functional outcomes of elderly patients treated with a volar locking plate for unstable distal radius fractures.

Methods: Thirty-two patients with a mean age of 74.1 (range, 65-85) years were followed for a mean of 39.1 (range, 30-81) months. Patients with follow-up periods of < 24 months were excluded from this study to investigate the mid-term clinical outcomes. The Mayo wrist score (MWS), grip strength and wrist range of motion were retrospectively reviewed at 12 months, 24 months and the latest follow-up (mean 39.1 months). Osteoarthritis status according to the system of Knirk and Jupiter was assessed at 24 months.

Results: Significant improvements in MWS and grip strength were observed between 12 and 24 months but not between 24 months and the final follow-up. There was no significant difference in wrist range of motion between 12 and 24 months. The MWS of 14 patients with radiographic signs of osteoarthritis was not significantly different from that of 18 patients without radiographic signs of osteoarthritis.

Conclusions: Elderly patients treated with the volar locking plate showed improved MWS and grip strength postoperatively after 12 months. Improvement in grip strength was slower than range of motion.

Keywords: Distal radius fracture; Elderly patients; Grip strength; Range of motion; Volar locking plate.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bone Plates*
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal*
  • Hand Strength / physiology
  • Humans
  • Male
  • Osteoarthritis / diagnostic imaging
  • Radius Fractures / physiopathology
  • Radius Fractures / surgery*
  • Range of Motion, Articular / physiology
  • Retrospective Studies
  • Wrist Joint / diagnostic imaging
  • Wrist Joint / physiopathology