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Original article

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Advanced volar locking plate fixation for intra and extra articular distal radius fractures: a retrospective study

By
Giuseppe Rovere ,
Giuseppe Rovere

Policlinico Tor Vergata, Rome

Francesco Bosco ,
Francesco Bosco

Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy.

Giulio Vigni ,
Giulio Vigni

Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy.

Ennio Sinno ,
Ennio Sinno

Orthopaedic and Traumatology Department, S. Spirito Hospital, Lungotevere in Sassia 1, 00193, Rome, Italy.

Andrea Perna ,
Andrea Perna

Department of Orthopedics and Trauma Surgery, Fondazione Casa Sollievo Della Sofferenza IRCCS, 71013, San Giovanni Rotondo, Italy

Fortunato Giustra ,
Fortunato Giustra

Department of Orthopaedics and Traumatology, Ospedale San Giovanni Bosco di Torino - ASL Città di Torino, Turin, Italy

Francesco Liuzza ,
Francesco Liuzza

Department of Clinical Science and Translational Medicine, Section of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Rome, Italy

Amarildo Smakaj ,
Amarildo Smakaj

Department of Clinical Science and Translational Medicine, Section of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Rome, Italy

Fernando De Maio ,
Fernando De Maio

Department of Clinical Science and Translational Medicine, Section of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Rome, Italy.

Antonio Ziranu ,
Antonio Ziranu

Ospedale Isola Tiberina - Gemelli Isola, Rome, Italy; Orthopedics and Traumatology, Università Cattolica Del Sacro Cuore, 00168 Roma, Italy

Giuseppe Tulumello ,
Giuseppe Tulumello

Department of Orthopaedics and Traumatology, Ospedale Giovanni Paolo II, Sciacca, italy

Lawrence Camarda
Lawrence Camarda
Contact Lawrence Camarda

Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy.

Editor: SELMA UZUNOVIĆ

Abstract

Background

Distal radius fractures are among the most common orthopedic injuries, posing significant challenges due to their high prevalence and potential for long-term functional impairment. Volar locking plates have emerged as the gold standard for managing unstable and extra-articular fractures, offering superior outcomes compared to traditional methods. This study evaluates the clinical, radiographic, and functional outcomes of volar locking plate fixation in 34 patients with intra and extra-articular distal radius fractures.

Methods

This retrospective study analyzed 34 patients treated for intra and extra-articular distal radius fractures with volar locking plates at a single orthopedic center. Patients were followed for a mean duration of 24 months (range: 12–36 months).

Outcomes were assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) score, Visual Analog Scale (VAS) for pain, range of motion (ROM), and radiographic parameters. Complications, including hardware-related issues and soft tissue irritation, were recorded. Statistical analysis compared preoperative and postoperative outcomes, with significance set at p < 0.05.

Results

The mean DASH score at the final follow-up was 4.2 ± 1.8, reflecting excellent functional recovery. Pain relief was complete, with all patients reporting a VAS score of 0. ROM restoration was highly satisfactory, achieving 93–98% of contralateral wrist motion. Radiographic evaluations confirmed 100% fracture consolidation with no cases of malunion or nonunion. Complications were minimal, with only two patients experiencing transient soft tissue discomfort, managed conservatively. No tendon irritation or hardware-related complications were observed.

Conclusions

Volar locking plate fixation for intra and extra-articular distal radius fractures demonstrated excellent clinical, functional, and radiographic outcomes in this cohort of 34 patients. The low-profile design and anatomical contouring of modern plates minimized complications while promoting effective pain relief and rapid functional recovery.

Author Contributions

Conceptualization, G.R., F.B., A.P., F.G. and F.L.; Investigation, G.R. and F.B.; Writing – original draft, G.R., F.B., G.V., E.S., A.S. and F.D.M.; Software, G.V., E.S., A.S. and F.D.M.; Data curation, A.P., F.G. and F.L.; Formal Analysis, A.P., F.G. and F.L.; Supervision, A.Z., G.T. and L.C. All authors have read and agreed to the published version of the manuscript.

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