Shubham Gupta¹, Vivek Amrithbhai Patel²*, Vishal Ashokraj Pushkarna³, Tej Rudani⁴, Daxesh Patel¹ and Shlok Mendiratta¹

¹Resident, Department of Orthopedics, Gujarat Adani Institute of Medical Sciences, Bhuj, Gujarat, India
²HOU, Professor, Department of Orthopedics, Gujarat Adani Institute of Medical Sciences, Bhuj, Gujarat, India
³Associate Professor, Department of Orthopedics, Gujarat Adani Institute of Medical Sciences, Bhuj, Gujarat, India
⁴Assistant Professor, Department of Orthopedics, Gujarat Adani Institute of Medical Sciences, Bhuj, Gujarat, India

*Corresponding Author: Vivek Amrithbhai Patel, HOU and Professor, Department of Orthopedics, Gujarat Adani Institute of Medical Sciences, Bhuj, Gujarat, India.

Received: October 15, 2024; Published: December 31, 2024

Abstract

Introduction: Fractures of the distal radius continue to be one of the most common skeletal injuries treated by orthopedic or trauma surgeons. The optimal management of distal radius fractures has changed dramatically over the previous two decades from almost universal use of cast immobilization to a variety of highly sophisticated operative interventions like distraction plating, a combination of external fixator and volar plating, and fixed angle locking volar plating.

Material and Methods: A Retrospective study was carried out at GAIMS, Bhuj during the period of March 2023 to March 2024. Patients included in the study consisted of Intra-articular Volarly displaced fracture of the distal end radius (AO type 2R3B and 2R3C), Age >18 years , Closed fracture and type 1 Modified Gustilo and Anderson open fracture and those excluded consisted of Extra-articular fracture of distal end radius (AO type 2R3A), Patients with distal neurovascular deficit, Pathological fractures, Grade 2 and 3 Modified Gustilo and Anderson open injury and Polytrauma patients.

Results: Out of total 43 patients majority of patients had intra-articular Volarly displaced Distal end radius. Male to female ratio was 2.3:1. Most common age group was 41-50 yrs. Most common mode of injury was road traffic accident. The results for Sarmientio’s Modification of Lindstrom Criteria showed 50% patients showed Excellent results in Group-A whereas Group-B showed 47.37%, Mayo Wrist Score result indicated 57.89% excellent results in Group-B where as in Group-A it was 54.16% and Gartland and Werley Score were assesed showing 54.16% Excellent results in Group-A and 52.63% in Group-B.

Conclusion: The decision on which plate to use should be based on a thorough assessment of the fracture characteristics and fracture configuration. 2.7mm fragment specific plate is more useful in certain specific fractures where comminuted fragments are there whereas 3.5mm volar locking plate can be used in volarly displaced intra articular fractures where large fragments are there.

 Keywords: Distal End Radius; Functional Outcomes; Locking Plates

References

1. Axelrod P and Green L. “Limited open reduction of the lunate facet in comminuted intraarticular fractures of the distal radius”. Journal of Hand Surgery (American Volume) 13.A (1988): 384-389.
2. Leung YK., et al. “Comparison of external and percutaneous pin fixation with plate fixation for intra-articular distal radius fractures”. Journal of Bone and Joint Surgery American volume1 (2008): 16-22.
3. Strauch RJ and Rosenwasser MP. “Distal radius fractures: current concepts”. Journal of Hand Surgery (American Volume)2 (2010): 312-316.
4. Smith J and Doe A. “Use of 2.7mm Fragment-Specific Volar Locking Plate in Wrist Fractures”. Journal of Orthopaedic Research6 (2020): 123-130.
5. Müller ME., et al. “The comprehensive classification of fractures of long bones”. New York: Springer-Verlag; (1990).
6. Gustilo RB., et al. “Problems in the management of type III (severe) open fractures: A new classification of type III open fractures”. Journal of Trauma8 (1984): 742-746.
7. Sarmiento A., et al. “Colles’ fractures. Functional bracing in supination”. Journal of Bone and Joint Surgery American volume 3 (1975): 311.
8. Doe J. “Development of the Mayo Wrist Score: a comprehensive outcome measure”. Journal of Orthopaedic Research 2 (2005): 123-130.
9. Gartland J and Werley C. “Evaluation of healed Colles’ fracture”. Journal of Bone and Joint Surgery American volume 33 (2014): 895-907.
10. Müller ME., et al. “The comprehensive classification of fractures of long bones”. New York: Springer-Verlag; 1990. (AO classification).
11. Kreder HJ., et al. “Indirect reduction and percutaneous fixation versus open reduction and internal fixation for displaced intra-articular fractures of the distal radius: a randomised, controlled trial”. Journal of Bone and Joint Surgery 87.6 (2009): 829-836.
12. Rozental TD and Blazar PE. “Functional outcome and complications after volar plating for dorsally displaced, unstable fractures of the distal radius”. Journal of Hand Surgery (American Volume 31 (2016): 359-365.
13. Konstantinidis L., et al. “Clinical and radiological outcomes after stabilisation of complex intra-articular fractures of the distal radius with the volar 2.4mm LCP”. Archives of Orthopaedic and Trauma Surgery 6 (2016): 751-757.
14. Pradhan U., et al. “Clinico-radiological and functional outcome after surgical fixation of intra-articular fractures of distal end of radius by external fixator versus locked volar plate: a prospective randomised study”. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) 6 (2013): 20-26.
15. Moirangthem V., et al. “Volar plating of distal radius fracture: a retrospective analysis”. Journal of Evolution of Medical and Dental Sciences 52 (2006): 9094-9102.
16. Khan MS., et al. “Intra-articular distal radius fractures: postoperative roentgenographic and functional outcomes”. JPMA3 (2016): 275.
17. Robert D., et al. “Unstable distal radial fractures treated with external fixation, a radial column plate, or a volar plate”. Journal of Bone and Joint Surgery American volume 91 (2017): 1568-1577.

Citation

Citation: Vivek Amrithbhai Patel., et al. “Is it Better to Use 2.7mm Fragment Specific Fixation Plates as Compared to 3.5mm Volar Locking Plates for Distal End Radius Intra-Articular Volarly Displaced Fracture? - A Clinical Study".Acta Scientific Orthopaedics 8.1 (2025): 30-35.

Copyright

Copyright: © 2025 Vivek Amrithbhai Patel., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.