Arch Hand Microsurg.  2021 Jun;26(2):93-99. 10.12790/ahm.21.0091.

The Usefulness of Radial Column Plate in Distal Radius Fracture: Indications and Results

• An SJ
• Lee SH
• Kim DH
• Jang HS
• Hong SM
• Kim HS

• KMID: 2516153
• DOI: http://doi.org/10.12790/ahm.21.0091

Abstract

Purpose
The most common surgical treatment for distal radius fracture is internal fixation using volar locking plates, but it is sometimes difficult to maintain reduction with them. Therefore, this research reports the results of surgical treatment with additional radial column plates.
Methods
We analyzed 12-month follow-up results in 100 cases. The patients had the B or C types of distal radius fractures, in accordance with AO classification, and underwent surgical treatment at our hospital from May 2013 to December 2019. There were 16 cases of B-type and 84 cases of C-type fractures. Out of these, 87 were treated with volar locking plates (V group) and 13 had additional radial column plates (VR group). The results of surgical treatment were examined clinically by measuring the disabilities of the arm, shoulder and hand (DASH) and Mayo wrist score, and radiologically by measuring the radial length, radial inclination, and volar tilt, before and after surgery.
Results
After treatment, the radiographic average in the V group showed a radial length of 12.3 mm, radial inclination of 20.2°, and volar tilt of 5.8°, while the VR group showed 11.6 mm, 22.3°, and 9.0° respectively. A statistically significant difference was found in the DASH score, and the DASH score showed good results in the VR group.
Conclusion
Additional radial column plate fixation is worth considering because it provides clinically and radiologically satisfactory results in treatment of B and C types distal radius fracture involving articular surface.

Keyword

Distal radius fractures; Radial column plates; Open reduction; DASH score; Intraarticular fractures

Figure

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  Fig. 1. Check the location and direction to avoid damaging the superficial radial nerve. Incise the extensor retinaculum in the shape of the figure above.

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  Fig. 2. A 40-year-old man with unstable distal radius fracture was treated with open reduction and internal fixation using volar locking plate and radial column plate. (A) Preoperative radiographs show AO classification C3. (B) Immediate postoperative radiographs show successful reduction and fixation. (C) Radiographs at 13 months postoperatively show no significant loss of reduction. (D) Postoperative radiograph after metal removal operation.

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  Fig. 3. A 53-year-old man with unstable distal radius fracture was treated with open reduction and internal fixation using volar locking plate and radial column plate. (A) Preoperative radiographs show AO classification C3. (B) Immediate postoperative radiographs show successful reduction and fixation.

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  Fig. 4. A 59-year-old woman with unstable distal radius fracture was treated with open reduction and internal fixation using volar locking plate and radial column plate. (A) Preoperative radiographs show AO classification C3. (B) Immediate postoperative radiographs using external fixator. (C) Postoperative radiographs show successful reduction and fixation after external fixator removal. (D) Postoperative radiograph after metal removal.

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