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Published in: Journal of Orthopaedic Surgery and Research 1/2019

Open Access 01-12-2019 | Distal Radius Fracture | Research article

Incidence of complications and secondary procedure following distal radius fractures treated by volar locking plate (VLP)

Authors: Yansen Li, Yanqing Zhou, Xiong Zhang, Dehu Tian, Bing Zhang

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2019

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Abstract

Objective

To investigate the incidence of postoperative overall complications or secondary procedures following distal radius fractures treated by volar locking plate (VLP)

Methods

Electronic medical records (EMR) of 1152 patients with 1175 distal radius fractures treated by volar locking plate between January 2013 and September 2018 were retrospectively reviewed and the data were extracted. The picture archiving and communication system (PACS) was inquired to assess the fracture severity and to determine the fracture type. Univariate and multivariate logistic regression analyses were used to identify the associated risk factors.

Results

During the median follow-up period of 6 months, a total of 138 complications in 131 patients were determined, indicating the accumulated rate of 11.7%; there were 68 cases of secondary procedures, with the rate of 5.8%. The independent associated factors for postoperative overall complications were AO type C fracture (OR, 2.6; 95%CI, 1.2 to 4.0), open fracture (OR, 4.2; 95%CI, 1.9 to 6.5), and significant collapse of the lunate fossa (OR, 2.9; 95%CI, 13 to 4.3), and for secondary procedures were significant collapse of the lunate fossa (OR, 3.7; 95%CI, 1.7 to 6.4) and the low-volume of surgeons (OR, 95%CI, 1.2 to 3.6)

Conclusions

Identification of these factors is of importance for the risk assessment of postoperative complications and the additional need of surgery. For patients with the above factors, especially those with combined risk factors, optimized operation scheme and high-volume surgeon should be considered to prevent or reduce the complications.
Literature
1.
go back to reference Zhang Y. Clinical epidemiology of orthopaedic trauma. Stuttgart: Thieme; 2016. Zhang Y. Clinical epidemiology of orthopaedic trauma. Stuttgart: Thieme; 2016.
2.
go back to reference Soong M, et al. Fracture of the distal radius: risk factors for complications after locked volar plate fixation. J Hand Surg Am. 2011;36(1):3–9.CrossRef Soong M, et al. Fracture of the distal radius: risk factors for complications after locked volar plate fixation. J Hand Surg Am. 2011;36(1):3–9.CrossRef
3.
go back to reference Zengin EC, et al. Cast immobilization versus volar locking plate fixation of AO type C distal radial fractures in patients aged 60 years and older. Acta Orthop Traumatol Turc. 2019;53(1):15–8.CrossRef Zengin EC, et al. Cast immobilization versus volar locking plate fixation of AO type C distal radial fractures in patients aged 60 years and older. Acta Orthop Traumatol Turc. 2019;53(1):15–8.CrossRef
4.
go back to reference Toon DH, et al. Outcomes and financial implications of intra-articular distal radius fractures: a comparative study of open reduction internal fixation (ORIF) with volar locking plates versus nonoperative management. J Orthop Traumatol. 2017;18(3):229–34.CrossRef Toon DH, et al. Outcomes and financial implications of intra-articular distal radius fractures: a comparative study of open reduction internal fixation (ORIF) with volar locking plates versus nonoperative management. J Orthop Traumatol. 2017;18(3):229–34.CrossRef
5.
go back to reference Walenkamp MMJ, et al. Functional outcome in patients with unstable distal radius fractures, volar locking plate versus external fixation: a meta-analysis. Strategies Trauma Limb Reconstr. 2013;8(2):67–75.CrossRef Walenkamp MMJ, et al. Functional outcome in patients with unstable distal radius fractures, volar locking plate versus external fixation: a meta-analysis. Strategies Trauma Limb Reconstr. 2013;8(2):67–75.CrossRef
6.
go back to reference Karantana A, et al. Surgical treatment of distal radial fractures with a volar locking plate versus conventional percutaneous methods: a randomized controlled trial. J Bone Joint Surg Am. 2013;95(19):1737–44.CrossRef Karantana A, et al. Surgical treatment of distal radial fractures with a volar locking plate versus conventional percutaneous methods: a randomized controlled trial. J Bone Joint Surg Am. 2013;95(19):1737–44.CrossRef
7.
go back to reference Hull P, et al. Volar locking plates versus K-wire fixation of dorsally displaced distal radius fractures--a functional outcome study. J Bone Joint Surg Am. 2011;70(6):125–8. Hull P, et al. Volar locking plates versus K-wire fixation of dorsally displaced distal radius fractures--a functional outcome study. J Bone Joint Surg Am. 2011;70(6):125–8.
8.
go back to reference McKay SD, et al. Assessment of complications of distal radius fractures and development of a complication checklist. J Hand Surg Am. 2001;26(5):916–22.CrossRef McKay SD, et al. Assessment of complications of distal radius fractures and development of a complication checklist. J Hand Surg Am. 2001;26(5):916–22.CrossRef
9.
go back to reference Bentohami A, et al. Complications following volar locking plate fixation for distal radial fractures: a systematic review. J Hand Surg Eur Vol. 2014;39(7):745–54.CrossRef Bentohami A, et al. Complications following volar locking plate fixation for distal radial fractures: a systematic review. J Hand Surg Eur Vol. 2014;39(7):745–54.CrossRef
10.
go back to reference Disseldorp DJ, et al. Dorsal or volar plate fixation of the distal radius: does the complication rate help us to choose? J Wrist Surg. 2016;5(3):202–10.CrossRef Disseldorp DJ, et al. Dorsal or volar plate fixation of the distal radius: does the complication rate help us to choose? J Wrist Surg. 2016;5(3):202–10.CrossRef
11.
go back to reference Thorninger R, et al. Complications of volar locking plating of distal radius fractures in 576 patients with 3.2 years follow-up. Injury. 2017;48(6):1104–9.CrossRef Thorninger R, et al. Complications of volar locking plating of distal radius fractures in 576 patients with 3.2 years follow-up. Injury. 2017;48(6):1104–9.CrossRef
12.
go back to reference Esenwein P, et al. Complications following palmar plate fixation of distal radius fractures: a review of 665 cases. Arch Orthop Trauma Surg. 2013;133(8):1155–62.CrossRef Esenwein P, et al. Complications following palmar plate fixation of distal radius fractures: a review of 665 cases. Arch Orthop Trauma Surg. 2013;133(8):1155–62.CrossRef
13.
go back to reference Johnson NA, et al. Complications after volar locking plate fixation of distal radius fractures. Injury. 2014;45(3):528–33.CrossRef Johnson NA, et al. Complications after volar locking plate fixation of distal radius fractures. Injury. 2014;45(3):528–33.CrossRef
14.
go back to reference Lutsky KF, et al. Incidence of hardware removal following volar plate fixation of distal radius fracture. J Hand Surg Am. 2015;40(12):2410–5.CrossRef Lutsky KF, et al. Incidence of hardware removal following volar plate fixation of distal radius fracture. J Hand Surg Am. 2015;40(12):2410–5.CrossRef
15.
go back to reference Tubeuf S, et al. Cost effectiveness of treatment with percutaneous Kirschner wires versus volar locking plate for adult patients with a dorsally displaced fracture of the distal radius: analysis from the DRAFFT trial. Bone Joint J. 2015;97-b(8):1082–9.CrossRef Tubeuf S, et al. Cost effectiveness of treatment with percutaneous Kirschner wires versus volar locking plate for adult patients with a dorsally displaced fracture of the distal radius: analysis from the DRAFFT trial. Bone Joint J. 2015;97-b(8):1082–9.CrossRef
16.
go back to reference Sirnio K, et al. Risk factors for complications after volar plate fixation of distal radial fractures. J Hand Surg Eur. 2018:1753193418811559. Sirnio K, et al. Risk factors for complications after volar plate fixation of distal radial fractures. J Hand Surg Eur. 2018:1753193418811559.
17.
go back to reference Ward CM, Kuhl TL, Adams BD. Early complications of volar plating of distal radius fractures and their relationship to surgeon experience. Hand (N Y). 2011;6(2):185–9.CrossRef Ward CM, Kuhl TL, Adams BD. Early complications of volar plating of distal radius fractures and their relationship to surgeon experience. Hand (N Y). 2011;6(2):185–9.CrossRef
18.
go back to reference Zhu Y, et al. Incidence and risks for surgical site infection after adult tibial plateau fractures treated by ORIF: a prospective multicentre study. Int Wound J. 2017;14(6):982–8.CrossRef Zhu Y, et al. Incidence and risks for surgical site infection after adult tibial plateau fractures treated by ORIF: a prospective multicentre study. Int Wound J. 2017;14(6):982–8.CrossRef
19.
go back to reference Disseldorp DJG, et al. Dorsal or volar plate fixation of the distal radius: does the complication rate help us to choose? Jnl Wrist Surg. 2016;05(03):202–10.CrossRef Disseldorp DJG, et al. Dorsal or volar plate fixation of the distal radius: does the complication rate help us to choose? Jnl Wrist Surg. 2016;05(03):202–10.CrossRef
20.
go back to reference Glueck DA, Charoglu CP, Lawton JN. Factors associated with infection following open distal radius fractures. Hand. 2009;4(3):330–4.CrossRef Glueck DA, Charoglu CP, Lawton JN. Factors associated with infection following open distal radius fractures. Hand. 2009;4(3):330–4.CrossRef
21.
go back to reference Tsang KH, et al. Locking plate for AO type C intra-articular distal radius fracture: volar or dorsal approach? 以鎖定鋼板治療AO- C型橈骨遠端關節內骨折 ---- 應使用掌側抑或背側入路? Journal of Orthopaedics, Trauma\s&\srehabilitation. 2014;18(2):83–8. Tsang KH, et al. Locking plate for AO type C intra-articular distal radius fracture: volar or dorsal approach? 以鎖定鋼板治療AO- C型橈骨遠端關節內骨折 ---- 應使用掌側抑或背側入路? Journal of Orthopaedics, Trauma\s&\srehabilitation. 2014;18(2):83–8.
22.
go back to reference Mekhail AO, et al. Anatomic and X-ray film studies of the distal articular surface of the radius. J Hand Surg Am. 1996;21(4):567–73.CrossRef Mekhail AO, et al. Anatomic and X-ray film studies of the distal articular surface of the radius. J Hand Surg Am. 1996;21(4):567–73.CrossRef
23.
go back to reference Rainbow MJ, et al. In vivo kinematics of the scaphoid, lunate, capitate, and third metacarpal in extreme wrist flexion and extension. J Hand Surg Am. 2013;38(2):278–88.CrossRef Rainbow MJ, et al. In vivo kinematics of the scaphoid, lunate, capitate, and third metacarpal in extreme wrist flexion and extension. J Hand Surg Am. 2013;38(2):278–88.CrossRef
24.
go back to reference Beck JD, Harness NG, Spencer HT. Volar plate fixation failure for volar shearing distal radius fractures with small lunate facet fragments. J Hand Surg Am. 2014;39(4):670–8.CrossRef Beck JD, Harness NG, Spencer HT. Volar plate fixation failure for volar shearing distal radius fractures with small lunate facet fragments. J Hand Surg Am. 2014;39(4):670–8.CrossRef
25.
go back to reference Harness NG, et al. Loss of fixation of the volar lunate facet fragment in fractures of the distal part of the radius. J Bone Joint Surg Am Vol. 2004;86(9):1900–8.CrossRef Harness NG, et al. Loss of fixation of the volar lunate facet fragment in fractures of the distal part of the radius. J Bone Joint Surg Am Vol. 2004;86(9):1900–8.CrossRef
26.
go back to reference Berglund LM, Messer TM. Complications of volar plate fixation for managing distal radius fractures. J Am Acad Orthop Surg. 2009;17(6):369–77.CrossRef Berglund LM, Messer TM. Complications of volar plate fixation for managing distal radius fractures. J Am Acad Orthop Surg. 2009;17(6):369–77.CrossRef
27.
go back to reference Schnall SB, et al. Fixation of distal radius fractures using a fragment-specific system. Clin Orthop Relat Res. 2006;445(445):51–7.PubMed Schnall SB, et al. Fixation of distal radius fractures using a fragment-specific system. Clin Orthop Relat Res. 2006;445(445):51–7.PubMed
28.
go back to reference Benson LS, et al. The outcome of intra-articular distal radius fractures treated with fragment-specific fixation. J Hand Surg Am. 2006;31(8):1333–9.CrossRef Benson LS, et al. The outcome of intra-articular distal radius fractures treated with fragment-specific fixation. J Hand Surg Am. 2006;31(8):1333–9.CrossRef
29.
go back to reference Lee HC, et al. Fixation of distal radius fractures using AO titanium volar distal radius plate. Hand Surg. 2003;8(01):7–15.CrossRef Lee HC, et al. Fixation of distal radius fractures using AO titanium volar distal radius plate. Hand Surg. 2003;8(01):7–15.CrossRef
30.
go back to reference Rhee SH, et al. Factors affecting late displacement following volar locking plate fixation for distal radial fractures in elderly female patients. Bone Joint J. 2013;95-B(3):396–400.CrossRef Rhee SH, et al. Factors affecting late displacement following volar locking plate fixation for distal radial fractures in elderly female patients. Bone Joint J. 2013;95-B(3):396–400.CrossRef
Metadata
Title
Incidence of complications and secondary procedure following distal radius fractures treated by volar locking plate (VLP)
Authors
Yansen Li
Yanqing Zhou
Xiong Zhang
Dehu Tian
Bing Zhang
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2019
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-019-1344-1

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