Volar plate fixation of AO type C2 and C3 distal radius fractures, a single-center study of 55 patients.

OBJECTIVES: We hypothesized that volar locked plate fixation of AO type C2 or C3 fractures could effectively maintain radiographic reduction as shown by comparison of immediate postoperative alignment and that seen after more than 12 months' follow-up.

DESIGN: Prospective cohort study.

SETTING: Level II trauma center located in a suburban area.

PATIENTS: Fifty-five adult patients with intra-articular fractures of the distal radius.

INTERVENTION: Open reduction and internal fixation with a locked volar plate and screws.

MAIN OUTCOME MEASUREMENTS: Volar tilt, radial inclination, radial length, and articular incongruity were radiologically assessed immediately postoperatively and at the time of final follow-up (mean follow-up: 29 +/- 7 months).

RESULTS: At final radiographic examination, the average loss of volar tilt was 1.9 +/- 3.3 degrees (P < 0.001) and the average loss of radial inclination was 1.4 +/- 2.8 degrees (P < 0.001). Four patients had more than 5 degrees loss of radial inclination (7.8%), and 22 patients (43.1%) had more than 5 degrees loss of volar tilt. Radial shortening was not statistically significant (P > 0.05).

CONCLUSIONS: The treatment of intra-articular fractures of the distal radius with a volar locked plating system is associated with a small but statistically significant loss of volar tilt and radial inclination upon comparison of immediate postoperative alignment with that seen after more than 12 months' follow-up.