• Brandon E Earp, Brian Foster, and Philip E Blazar.
• Department of Orthopaedics, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115 USA.
• Hand (N Y). 2015 Dec 1; 10 (4): 649-53.

BackgroundA single volar locking plate (VLP) is now frequently used for open reduction and internal fixation (ORIF) of many types of distal radius fractures. Comminuted intra-articular distal radius fractures (AO C3-type) are typically the most challenging to surgically treat. No studies directly address the adequacy of a VLP alone for maintaining reduction of AO C-type fractures. We hypothesized that a single VLP provides an effective method for maintaining reduction for these fractures.MethodsWe retrospectively evaluated radiographs of a series of AO C-type fractures. Seventy-seven patients with 77 AO C3-type fractures were identified from billing records and were eligible for the study. All patients were treated by fellowship-trained hand surgeons. Radiographs at the time of union were compared to those from immediately postoperatively.ResultsSixty-nine of 77 (89.6 %) fractures treated with VLP fixation alone for AO C3-type distal radius fractures united without loss of reduction. Eight of 77 (10.4 %) patients treated with VLP for AO C3 fractures lost reduction. The most common fracture fragment to lose reduction was the lunate fossa (5 of 8); loss of reduction of the scaphoid fossa die-punch fragment (2 of 8) and the radial styloid (1 of 8) were also seen.ConclusionsThe majority (89.6 %) of AO C3-type fractures treated with a single volar locking plate come to union without loss of reduction.Level Of EvidenceLevel IV.

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