Published online Oct 18, 2018. doi: 10.5312/wjo.v9.i10.203
Peer-review started: April 30, 2018
First decision: May 16, 2018
Revised: June 28, 2018
Accepted: August 20, 2018
Article in press: August 21, 2018
Published online: October 18, 2018
To determine factors correlated with postoperative radial shortening in patients with distal radius fractures treated with volar locking distal radius plates.
A total of 250 patients with a distal radius fracture stabilised with volar locking plates between January 2010 and December 2014 were included in a multicentre retrospective cohort study. We measured the distance of the distal locking screws to the joint line immediately postoperatively and then measured radial shortening after six to eight weeks using the change in ulnar variance.
Multivariate linear regression analysis showed that there was a significant linear association between the distance of the screws from the joint line and radial shortening. No other patient, injury, or treatment-related characteristic significantly influenced radial shortening in multivariate analysis.
Distal locking screws should be placed as close as possible to the subchondral joint line to prevent postoperative loss of reduction.
Core tip: The aim of this study was to determine risk factors for postoperative radial shortening in patients with distal radius fractures treated with volar locking distal radius plates. Retrospective analysis of 250 X-rays and clinical data determined immediate post-operative distance of the distal locking screws from the joint line and degree of radial shortening 6-8 wk post-operatively. Radial shortening was significantly and linearly correlated with increased distance of locking screws from the joint line. No other factor analysed in the study was significant. We recommend subchondral placement of distal locking screws in order to maintain reduction postoperatively.