J Korean Soc Surg Hand.  2013 Sep;18(3):118-123. 10.12790/jkssh.2013.18.3.118.

Relationship between the Length of Distal Locking Screws and Diaphyseal Screws in Volar Plate Fixation of Distal Radius Fractures

• Huh SW
• Lee JY
• Kim NH
• Park IJ
• Chung YG
• Song SW

• KMID: 2194141
• DOI: http://doi.org/10.12790/jkssh.2013.18.3.118

Abstract

PURPOSE
To determine the relationship between the length of distal locking screws and diaphyseal screws in volar plate fixation of distal radius fractures.
METHODS
A retrospective review was performed of 169 patients who underwent volar locking plate fixation for treatment of distal radius fractures. All patients received 2.4 mm LCP volar extra-articular distal radius plate (DePuySynthes). The length of the diaphyseal screw which was placed in the elongated hole was correlated with the length of a distal locking screw from radial most (D1) to ulnar most (D4). We also evaluated distal screw penetration of the dorsal cortex and plate removal rate.
RESULTS
The length of the diaphyseal screw which was placed in the elongated hole strongly correlated with the length of a distal locking screw. Average D1 screw length was 2 mm longer than the diaphyseal screw, and average D2 screw length was 4 mm longer than the diaphyseal screw. D3 and D4 screw were 6 mm longer than the diaphyseal screw. Plate removal was necessary in 13 patients (8%) due to screw irritation. These patients had significantly longer screws than average. Flexor or extensor tendon ruptures did not occur in this cohort.
CONCLUSION
The length of the distal locking screws can be estimated with the length of the diaphyseal screw. This information may help surgeons to select the adequate length of distal locking screws during volar plating of distal radius fractures.

Keyword

Distal radius fractures; Volar locking plate; Screw length

MeSH Terms

Humans
Radius
Radius Fractures
Retrospective Studies
Rupture
Tendons
Palmar Plate

Figure

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  Fig. 1. (A) The length of the distal locking screw was measured from radial (D1) to ulnar (D4) and correlated with that of the cortical screw placed in the elongated hole (S). (B) The length of the distal locking screw was determined by measuring depth gauze and subtracting 2 mm.

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  Fig. 2. Relationship between the length of distal locking screws and diaphyseal screws in volar plate fixation of distal radius fractures. Black bar represents the length of D1, while white bar represents the length of D4. Error bar represents standard deviation.

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  Fig. 3. (A) The distal locking screw in the intermediate column (white arrow) was not protruded when it was 4 mm longer than the cortical screw. (B) The distal locking screw in the intermediate column (white arrow) was protruded from the cortical bone when it was 6 mm longer than the cortical screw. The plate and screws have to be removed because of the extensor tendon irritation.

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