[Radiographic measurements and secondary displacement in patients with open reduction and volar plate fixation of distal radius fractures].

Abstract

Introduction: distal radius fractures are an important cause of disability in adults. Fracture displacement and malunion are known and common complications of treatment. Open reduction and fracture fixation with volar plates and screws restore the normal alignment of the radius, but there are few reports in the literature regarding secondary displacement of the fracture fragments.

Objective: detect secondary displacement in patient receiving distal radius open reduction and internal fixation with volar plates in the last five years at a private third level hospital.

Material and methods: a total of 54 patients satisfied our inclusion criteria. Radiographic measurements were taken on standard anteroposterior (AP) and lateral films, preoperative, immediate postoperative and six weeks postoperative. We considered significant displacement as follows: More than 5° of volar tilt or radial inclination change, and more than 1 mm displacement in ulnar variance or radial height.

Results: all patients presented some degree of postoperative displacement, only seven patients were affected with displacement above our defined threshold. One patient displaced over acceptable reduction parameters. Statistical analysis with ² test determined that female sex was the only significant risk factor for displacement in this study. Binary logistic regression analysis didn't find any significant risk factors.

Conclusions: in these series, female sex was the only risk factor for postoperative displacement. This displacement probable is not clinically significant. Long term follow-up and increasing the number of patients can give more power to our evidence.