The use of volar locked plate in fractures of distal radius

Abstract

Fractures of distal radius are the most common forearm fractures.The most common mechanism of the fracture is fall on outstretched hand. Many classifications were prescribed for the fracture, including Eponym, Frykmann, Fernandez, Universal, AO, Doi and much others.Diagnosis and management plan depend on history, clinical and radiological findings. The aim of treatment is a wrist with adequate painfree motion and stability allowing daily activities, with no obvious deformity, without future degenerative changes. The use of volar locked plate for most of varieties of distal radial fractures had proved its efficacy in achieving good functional results, with less time of immobilization and early rehabilitation which was believed economically and socially better than the other treatment modalities as cast, pinning, external fixators, conventional plating. However some cases required the addition of K-wires, dorsal, or fragment specific plates for better results. Biomechanically, the volar locked plate provided the solution to the challenge of distal fragment fixation as these implants did not require screw purchase into the distal fragment and therefore were less likely to loosen and toggle. They functioned as internal-external fixators avoiding disadvantages of external fixators, and also as nails, giving support by interference fit. Biologically, volar locked plate with their reliance on the tough subchondral bone support had offered a valuable solution in management of insufficiency fractures of distal radius in elderly population due to osteoporosis, which are characterized by compression failure of metaphyseal bone with defect and severe comminution.They also offered the solution for the increasing high energy fractures due to traffic accidents which are characterized by being more in young patients, their severe intra-articular patterns with massive bone comminution and great disruption of articular congruity.The use of the volar locked plate