A novel technique for full anatomic restoration of volar tilt in distal radius fracture

Abstract

Objective: We presented a technique that allows the surgeon to easily and reliably achieve volar tilt in dorsally displaced distal radius fractures treated with variable-angle volar locking plates. The purpose of this study was to introduce this technique using 2.4-mm variable angle locking screws as reduction tools and investigated radiologic outcomes of this technique.
Patients and Methods: Total 42 patients with unstable distal radius fractures were treated with this technique. This technique applied the patients with insufficient volar tilt in spite of primary fracture reduction through classic reduction techniques such as traction, manipulation, and direct fragment manipulation. All patients were evaluated radiographically at minimum twelve months after the surgery.
Results: Thirty female patients and twelve male patients (mean age, 58 years) were included. Follow-up was an average of 15.1 months. The volar tilt of distal radius before surgery is - 11.9 ± 10.4, and the volar tilt after screw leverage 11.5 ± 4.3° (uninjured side: 11.7 ± 2.3°). The mean radiologic outcomes at final visit were as follows. Volar tilt was 10.8 ± 4.5°, radial inclination was 24 ± 3.2°, radial height was 12.2 ± 1.7 mm, and ulnar variance was 0.2 ± 1.7 mm.
Conclusion: We describe a simple, reliable technique to fine-tune the volar tilt of dorsally displaced distal radius fractures fixed with variable-angle volar locking plates. This technique is especially useful when volar tilt remains insufficient in spite of primary fracture reduction through classic techniques.

 

DOI: 10.3944/AOTT.2015.14.0247
This abstract belongs to the un-edited version of the article and is only for informative purposes. Published version may differ from the current version.

Keywords

• Distal radius fracture;volar locking plate;variable angle locking plate;reduction technique;screw leverage.