Clinicoradiological Outcome of Intra Articular Distal End Radius Fracture with Volar Locking Plates

Introduction: The most common trauma mechanism is falling over the outstretched hand. The desire for anatomical restoration of the distal radial joint is the rationale for operative treatment. Distal end radius fracture is frequently comminuted & this is responsible for slipping of the reduction, which is a rather common late feature. Open reduction and internal fixation is indicated to address the unstable distal radius fractures and those with articular incongruity that cannot be anatomically reduced & maintained through external manipulation and ligamentotaxis alone. Methodology:60 indoor patients, befitting the inclusion criteria, who have consecutively consented for the study and undergone ORIF of fractures of the DRFs using locking compression plates through a volar approach at Nanavati Hospital, Mumbai between June 2014 and Feb 2016 were assessed & followed up at serial intervals. The evaluation of clinicoradiological outcomes of these patients was done at follow up using the Demerit Point scoring system of Gartland and Werley with Sarmiento Modification. Results: The study comprised of 60 subjects, 28 male & 32 females, between the ages of 25 and 82 years who suffered intra-articular DRFs and managed operatively ? ORIF using volar LCP at our hospital. Average time to surgery from time of injury was 1.75 days. Patients were asked to follow up routinely, with post operative follow up ranging from 12 weeks to 18 months. Scoring System results obtained were as follows: 63% patients ? Excellent, 32% patients ? Good, 5% patients ? Fair, 0% patients ? Poor. Conclusion: Intra-articular DRFs represent a therapeutic challenge as compared with unstable extra-articular fractures. With the recent development of specifically designed locking implants for the distal radius, fragment-specific fixation has emerged as an option. ORIF using volar locking compression plates has shown to be a valid treatment option for unstable, Displaced & distal radius intra articular fracture.