Arch Hand Microsurg.  2019 Sep;24(3):234-242. 10.12790/ahm.2019.24.3.234.

A Prospective, Multicenter, Observational Study to Assess Distal Radius Fracture Treatment Outcomes Using the Variable-Angle Locking Compression Plate

• Yoo SL
• Lee HJ
• Han SH
• Kim JK

• KMID: 2456247
• DOI: http://doi.org/10.12790/ahm.2019.24.3.234

Abstract

PURPOSE
The 2.4 mm variable-angle locking compression plate (VA-LCP) is designed to treat a variety of distal radius fracture patterns. The purpose of this study was to evaluate the efficacy of the 2.4 mm VA-LCP in treating unstable distal radius fractures.
METHODS
We recruited eligible patients treated with the device at two Korean sites. In total, we studied 61 enrolled patients. We assessed clinical outcomes and radiographic union, as well as the types of plates and the number of variableangle locking screws used in the treatment of each fracture type. Radiographic parameters were evaluated at the immediate postoperative period and at 1 year after operation.
RESULTS
A total of five complications occurred in 61 patients (8.2%). Radiographic union was achieved in 46/51 (90.2%), 50/51 (98.0%), and 51/51 (100%) patients at 3, 6, and 12 months, respectively. Radiographic parameters evaluated at the immediate postoperative period were 22.4±4.2 degrees (radial inclination), 4.7±0.4 degrees (volar tilt) and 0.8±0.2 degrees (ulnar variance). Radiographic parameters evaluated at 1 year after operation were 21.3±3.4 degrees (radial inclination), 4.1±0.4 degrees (volar tilt) and 1.2±0.3 degrees (ulnar variance). Wrist range of motion and grip strength measurements, as well as self-administered patient questionnaires showed continuous improvements at all follow-up time points. The mean number of screws that were inserted through variable-angle screw guide was 3.2±0.9, while that of screws inserted through fixed-angle screw guide was 3.5±0.9. The majority of patients (85.3%) were treated with a narrow plate.
RESULTS
The findings of this study show promising results for the treatment of unstable distal radius fractures using the VA-LCP System.

Keyword

Radius; Radius fracture; Variable-angle locking compression plate

MeSH Terms

Follow-Up Studies
Hand Strength
Humans
Observational Study*
Postoperative Period
Prospective Studies*
Radius Fractures*
Radius*
Range of Motion, Articular
Wrist

Figure

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  Fig. 1. The mean wrist range of motion in degrees including flexion/extension, pronation/supination, and radial deviation/ ulnar deviation increased continuously until the end of the study. ROM: range of motion.

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  Fig. 2. Grip strength in kilograms of the fractured limb compared to the non-fractured limb at each follow-up visit. The difference decreased between the 6- and 12-month time points, suggesting recovery of grip strength following fracture union.

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  Fig. 3. (A, B) In intra-articular fractures with sigmoid notch involvement, (C) distal fragment that involved sigmoid notch could be fixed more stably by varying the angle of the ulnar-most screw.

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