Adjustable and ordinary locking compression plates for the repair of osteoporotic distal radius fractures：comparison of radial length and wrist function recovery

Wang Bin; Gao Yi; Xu Jian-da; Xie Zi-kang; Shen Peng-fei; Zheng Chong; Qu Yu-xing

doi:10.3969/j.issn.2095-4344

Abstract：BACKGROUND:Locking compression plate in the treatment of osteoporotic distal radius fractures has achieved good results, but the changes in anatomic parameters of the distal radius after fixation with different kinds of plates remain unclear. <br> OBJECTIVE:To investigate the clinical outcomes of the adjustable locking compression plate for treatment of osteoporotic distal radius fractures by comparing with the ordinary locking compression plate. <br> METHODS:A total of 38 patients with osteoporotic distal radius fractures, who were treated in the Department of Orthopedics, Changzhou TCM Hospital Affiliated to Nanjing University of Traditional Chinese Medicine from January 2012 to January 2014, were retrospectively analyzed. According to the fixation schemes, the patients were divided into adjustable locking compression plate group (n=22) and ordinary locking compression plate group (n=16). Fractures were assessed by the AO type, and al incisions were from palm side. The volar tilt, radial inclination, and radial length were recorded and compared between the two groups after surgery and during final folow-up. Wrist function was assessed according to Denis Standard. <br> RESULTS AND CONCLUSION: Al patients were folowed up from 5-26 months. Al the patients got bone union at an average of 12.3 weeks (range from 9-16 weeks). The volar tilt was 10.6° and 11.3°, and the radial inclination was 21.1° and 19.2° in average instantly after operation, respectively in two groups. At the latest folow up, the volar tilt was 8.5° and 8.5°, and the radial inclination was 17.9° and 15.8° in average, respectively, which did not show significant differences (P > 0.05). The radial shortening values were 0.5 mm and 1.1 mm instantly after operation in two groups. At the latest folow up, the radial shortening values were 0.9 mm and 1.4 mm during final folow-up in the two groups, which exhibited significant differences (P < 0.05). According to Dienst assessment, in adjustable locking compression plate group, 16 cases were excelent, and 6 were good. In ordinary locking compression plate group, 11 cases were excelent, and 5 were good. There was no statistical difference between the two groups (P > 0.05). These results confirmed that the adjustable locking compression plate can obtain good volar tilt, radial inclination and wrist function in treating the osteoporotic distal radius fractures. Compared to the ordinary locking compression plate, it has better restoration of the radial length, which can be maintained during the folow up.