Volar locking compression plating versus dorsal plating for fractures of the distal radius. A prospective, randomized study

Introduction. This study investigated the radiographic and functional outcomes of two different methods for treating fractures of the distal part of the radius. Patients and methods. In a prospective controlled study patients with forearm fractures were randomized by age, handedness, and fracture type. Results. The study included 120 patients, with a mean age of 66 years. Forty-nine percent of the fractures were extraarticular, and 51% were intraarticular. In the group treated with volar locking compression plates, six patients needed operative decompression of the median nerve and one needed reconstruction of the extensor pollicis longus (EPL) tendon. The group with dorsal plating had three complications requiring operative treatment: one deep infection, one dislocation of the plate, and one reconstruction of the EPL tendon. The radiological results for the Stewart 1 score showed 68% excellent results in volar locking compression plating compared with 57% in dorsal plating. Regarding functional outcome, 48% with volar plating showed excellent results compared with 22% with dorsal plating, as measured by the Stewart 2 score. Conclusion. Despite significant advantages of the volar locked compression plating, subjective satisfaction did not differ between the two groups.