Clinical Results of Volar Locking Plate for Distal Radius Fractures: Conventional versus Minimally Invasive Plate Osteosynthesis

Abstract

The purpose of this study was to compare the postoperative radiologic and clinical outcomes of conventional plate osteosynthesis (C) with minimally invasive plate osteosynthesis (M) using a transverse skin incision without cutting the pronator quadratus muscle for distal radius fractures. Retrospective consecutive cohort with prospective data collection. One community teaching hospital. Surgical treatment was performed by a single surgeon. Sixty-six patients (C group, 36; M group, 30) underwent open reduction and internal fixation of dorsally displaced distal radius fractures with the volar locking plating system from June 2006 to August 2008. Their mean age was 63.5 years and the mean follow-up period was 22.7 months. Radiologic parameters (volar tilt, radial inclination, ulnar variance), range of motion, grip strength, and Disability of the Arm, Shoulder, and Hand score were evaluated at each examination. The visual analog scale of wrist pain and evaluations of cosmetic problems were assessed at the final follow-up. The groups did not differ significantly in all main outcomes. In the M group, the mean values of the Disability of the Arm, Shoulder, and Hand score at 2 weeks postoperatively (P = 0.06) and visual analog scale (P = 0.07) were lower and the mean value of the patient's satisfaction score of cosmetic problems (P = 0.08) was higher than those in the C group, but no statistically significant differences were apparent in these values. No significant differences were found between the minimally invasive plate osteosynthesis and conventional plating for distal radius fractures based on the data from postoperative radiologic and clinical outcomes.