(The) preliminary report on Korean-type distal radius anatomical volar plate system

Abstract

Introduction: Distal radius fracture is the most common fracture of the upper extremity, and approximately 60,000 distal radius fractures occur annually in Korea. Internal fixation with an anatomical volar locking plate is widely used in the treatment of unstable distal radius fractures. However, most of the currently used distal radius anatomical plate systems were designed based on the anatomical characteristics of Western populations. Recently, the Korean-type distal radius anatomical volar plate (K-DRAVP) system was designed and developed based on the anatomical characteristics of the distal radius of Koreans. The purpose of this study was to evaluate the preliminary results of the new K-DRAVP system, and to compare the radiologic and functional results with those of other systems.

Methods: From March 2012 to October 2012, 46 patients with acute distal radius fractures who were treated with the K-DRAVP system at 3 hospitals were enrolled in this study. Standard posteroanterior and lateral radiographs were obtained to assess fracture healing, and three radiologic parameters (volar tilt, radial inclination, and radial length) were assessed to evaluate radiologic outcomes. The range of motion and grip strength, the Gartland and Werley scoring system, and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire were used to assess clinical and functional outcomes.

Results: Bony union was achieved in all fractures with a mean time of 42 days. All radiologic parameters were restored to normal ranges, and maintained without any loosening or collapse by the time of final follow-up. Grip strength was restored to 84% of the value of the unaffected side. The mean range of motion of the wrist at final follow-up was 56.2° extension, 51.3° flexion, 15.6° radial deviation, 25.9° ulnar deviation, 81.0° pronation, and 79.6° supination (77–95% of the value of the unaffected side). According to the Gartland and Werley scoring system, there were 16 excellent, 26 good, and 4 fair results. The mean DASH score was 8.4 points. There were no complications after surgery.

Conclusion: The newly developed K-DRAVP system could be used to restore and maintain good anatomical parameters, and provide good clinical outcomes with low complication rates. This system is a promising surgical option for the treatment of distal radius fractures in the Korean population.