Locking Volar Plate in Distal Radius Fractures: Minimally Invasive Technique versus Conventional Technique

Abstract

Introduction In recent years, surgery has gained relevance in the treatment of distal radius fractures (DRF). Among the surgical techniques, minimally-invasive plate osteosynthesis (MIPO) is becoming popular, and its indications are increasing compared to the conventional technique.

Material and Methods A retrospective study that included 81 patients who went through surgery for DRF during 2021, corresponding to fractures of types I, II, and III in the Fernández classification. Radiological, clinical, and functional results, as well as the appearance of complications, were compared at the end of the 6-month follow-up.

Results The MIPO group was composed of 21 patients (8 men and 13 women) with a mean age of 57.3 years, and the conventional group, 60 patients (11 men and 49 women) with a mean age of 60.8 years. The Castaing Radiological Scale showed a favorable overall result for the MIPO technique compared to the conventional technique (p = 0.049), with statistically significance for the MIPO group in terms of sagittal/volar inclination (10.5 vs. 7.3°; p = 0.0006). The Visual Analogue Scale (VAS) yielded a result of 1.5 for the MIPO technique and of 2.9 for the conventional technique (p = 0.0141). The score on the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire was slightly higher in the MIPO group (13.5%) compared to the conventional group (19.6%), but it was not statistically significant. Similar results were found for the range of motion (ROM), except for pronation and grip strength, which were favorable for the MIPO group. Complications, including nerve injury, chronic pain, tendon injury, and esthetic sequelae, were higher in percentage with the conventional technique.

Conclusion For the treatment of DRF, the MIPO technique, using an extra-short plate through a biological approach, can achieve functional results at least as good as those achieved with the conventional technique, with better radiological results, lower levels of postoperative pain, a lower rate of complications, and better esthetic results.

Keywords

distal radius fracture - osteosynthesis - plate - minimally-invasive surgery

Publication History

Received: 09 January 2024

Accepted: 01 April 2024

Article published online:
07 June 2024

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