The Rate of Major Complications Following Distal Radial Fractures Treated With One Specific Volar Locking Plate: A Retrospective Study of 1,597 Consecutive Cases in 1,564 Patients.

Abstract

Purpose: Current knowledge of complication rates after volar plating of distal radius fractures mainly relies on studies of low to moderate numbers and various implants. This study sought to find the incidence of complications leading to reoperation in a sample of distal radius fractures treated with one specific volar locking plate (VLP).

Methods: We retrospectively evaluated 1,597 distal radius fractures in 1,564 patients operated with a VLP from January 2011 to December 2017 for complications leading to a reoperation. We considered any reoperation a major complication, except for carpal tunnel syndrome surgery and removal of hardware not caused by intra- or extra-articular screw penetration. Postoperative information was assessed for a minimum of 5 years or until death.

Results: The total complication rate was 7.5% (120 of the 1597 cases). Major complications accounted for 3.9% (n = 62) and minor complications 3.6% (n = 58). Implant extraction not attributed to screw penetration (n = 34, 2.1%) and postoperative carpal tunnel syndrome (n=24, 1.5%) were the most frequent. No flexor tendon ruptures occurred. There were four (0.3%) extensor pollicis longus ruptures but no other extensor tendon ruptures. Deep infections were rare, occurring in only four cases (0.3%).

Conclusions: Treatment of unstable distal radius fractures with a VLP is associated with few major complications. Minor procedures, like carpal tunnel release, and removal of hardware without objective clinical or radiological indications, accounted for almost half of the reoperations.

Type of study/level of evidence: Prognostic IV.