Associations Between the Fracture Type and Functional Outcomes After Distal Radial Fractures Treated With a Volar Locking Plate

Objective. The aim of this study to investigate the associations of fracture type, age, and gender with hand function after distal radius fractures treated with a volar locking plate at a 6-month follow-up.
Material and Methods. A total of 120 patients with displaced distal radius fractures were included into the study. They were operated on using a volar locking plate system. All the fractures were classified according to the AO classification, and the patients were divided into 3 groups by the fracture type. The range of motion and grip strength were evaluated at the 6-month follow-up. Multivariate linear regression analysis was used to evaluate the associations of age, gender, and fracture type with the score of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. The DASH questionnaire was completed as an outcome measure.
Results. A total of 28 patients experienced type A fractures; 70 patients, type B fractures; and 22 patients, type C fractures. No statistically significant difference regarding age and sex among the groups was observed. At 6 months after the surgery, the mean DASH score for type A, B, and C fractures was 16, 13, and 32, respectively (P=0.01). After the surgery, the radiographic parameters such as the volar tilt and the ulnar variance were significantly worse in the patients with type C fractures. Grip strength and the range of motion of the contralateral healthy hand at the 6-month follow-up were significantly better than those of the operated hand. The linear regression analysis showed that the type C fracture was the only factor significantly associated with lower DASH score.
Conclusions. The patients with type C fractures treated with a volar locking plate had a worse wrist function as compared with the patients type A and B fractures at the 6-month follow-up. The postoperative hand function was significantly associated only with the type C fracture, while age and gender had no significant impact.