FUNCTIONAL OUTCOME OF VOLAR LOCKING PLATE FIXATION IN ADULTS FOR DISPLACED INTRA ARTICULAR FRACTURE OF DISTAL RADIUS

Abstract

Background: Distal radius fractures are among the most frequently encountered orthopedic injuries, particularly affecting children, adolescents, and elderly individuals due to falls on an outstretched hand (FOOSH). These fractures can severely impair wrist function and require timely and effective intervention. Volar locking plate fixation has emerged as a preferred surgical technique for managing displaced intra-articular fractures due to its superior biomechanical stability and ability to maintain fracture reduction. Despite its widespread use, limited local data exists on functional outcomes, especially in adult populations.

Objective: To evaluate the functional outcomes of volar locking plate fixation in adult patients with displaced intra-articular distal radius fractures using the Disabilities of the Arm, Shoulder, and Hand (DASH) score.

Methods: This prospective descriptive study was conducted over a six-month period at the Orthopedic Department of Combined Military Hospital, Peshawar. A total of 97 adult patients aged between 18 and 70 years with radiologically confirmed displaced intra-articular distal radius fractures were included using non-probability consecutive sampling. Patients with open fractures, ipsilateral upper limb involvement, or pre-existing deformities were excluded. All patients underwent fixation with a volar locking plate under general anesthesia. Functional recovery was assessed at 10 weeks postoperatively using the DASH questionnaire. Data were analyzed using SPSS version 21, with descriptive and inferential statistics applied, including stratification by age, gender, socioeconomic status, and BMI.

Results: The mean DASH score was 28.6 ± 8.3. A total of 45 patients (46.4%) had excellent outcomes, 30 (30.9%) had good outcomes, 15 (15.5%) had fair outcomes, and 7 (7.2%) had poor outcomes. Younger age and higher socioeconomic status were significantly associated with better outcomes. Minor complications included transient median nerve irritation in 5 patients (5.2%), superficial infections in 3 (3.1%), and plate loosening in 1 patient (1.0%).

Conclusion: Volar locking plate fixation is a safe and effective treatment for displaced intra-articular distal radius fractures in adults, offering favorable functional outcomes and low complication rates. Tailored rehabilitation based on individual patient characteristics can further enhance recovery.