Volar locking plate fixation tied to stable anatomical reduction in distal radius fractures with excellent functional recovery: study

Most frequent injuries of the Upper limb are a distal radius fracture (DRF). If they arent handled well, they might cause problems for a long time. There are several techniques to treat this issue, but volar locking plate fixation has become increasingly prevalent since it may restore anatomical alignment, provide stable fixation, and allow for early movement. This study aimed to evaluate the functional and radiological results of distal end radius fractures treated with volar locking plate fixation.

Mahesh Mohankumar et al conducted a prospective analytical investigation, 60 patients with DRFs, ranging in age from 18 to 80 years, were enrolled. Patients were treated with open reduction and internal fixation using volar locking devices. Functional results are evaluated using the Gartland and Werley Demerit Point System and goniometry. Radial length, radial inclination, palmar tilt, and articular step-off were employed to quantify radiological outcomes. Follow-up evaluations were conducted at 2, 4, and 6 weeks, in addition to 6 months. We used the Statistical Package for the Social Sciences version 20 to analyze the data and discovered that P < 0.05 was significant.

The key findings of the study were:

Patients exhibited substantial improvement in wrist function across all planes of motion, with plantar flexion rising from 31.6° at 2 weeks to 67.8° at 6 months, and dorsiflexion from 31.7° to 66.4°. Supination and pronation also became a lot better, becoming close to normal levels after 6 months. The radiographic restoration was good, with a mean radial length of 8.8 mm, an inclination of 17.6°, and a palmar tilt of 8.9°.There were very few complications (6.7% arthritis, 6.7% malunion).

The authors commented – “Our results support previous research showing volar plating offers robust fixation, restores anatomical alignment, and facilitates early mobility. Correlation study revealed that palmar tilt and articular congruity substantially impacted functional recovery, emphasizing the need of meticulous surgical reduction.”

The authors concluded – “The current prospective research revealed that volar-locking plate fixation for DRFs guarantees exceptional functional recovery, continuous enhancement of wrist and forearm mobility, and dependable radiological restoration with low sequelae. Restoring anatomical features, especially palmar tilt and articular congruity, had a big effect on functional results, which shows how important it is to do a precise surgical reduction. Our results corroborate the effectiveness and safety of volar plating as a preferred treatment approach, providing stable fixation, early mobilization, and sustained recovery across various patient populations, in comparison to data from other research.”

Further reading:

Functional outcomes of arthroscopic rotator cuff repair: transosseous technique versus single-row with anchors

Mahesh Mohankumar et al

Journal of Orthopaedic Case Reports 2025 December:15(12):Page 421-429