Lange termijn resultaten van distale radius fracturen behandeld met een volaire hoekstabiele plaat

Background: The best treatment for unstable distal radius fractures is still unclear. According to the Dutch guideline for treatment and diagnosis of distal radius fractures, a volar locking compression plate is the treatment of choice. There are no studies regarding this type of osteosynthesis with a follow-up exceeding 48 months. Methods: Patients who received surgery for distal radius fractures between 2004 and 2010 at the Deventer hospital who where treated by means of a volar locking compression plate where invited for a one-time follow-up visit. Functional tests and questionnaires were taken. After this conventional radiographs were made. We compared the DASH score with known literature and functional results from the operated side to the healthy wrist. Radiologic parameters were compared to normal values. Results: 41 out of 107 selected patiënts were evaluated at the outpatient clinic. We reached an average follow-up of 45,2±16,2 months. Average DASH score was 10,3±10,2 and did not differ from population average or DASH score at 24months follow-up in literature. There was a significant loss of function in the operated wrist and there are signs of joint-incongruence and osteoartrosis. Conclusion: Volar locking compression plates for the treatment of distal radius fractures demonstrate good long-term results. The wrist however suffers from long-term functional constraints. Despite modern techniques posttraumatic osteoartrosis still occurs.