• Luigi Tarallo, Raffaele Mugnai, Francesco Zambianchi, Roberto Adani, and Fabio Catani.
• *Orthopaedics and Traumatology Department, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy; and †Hand and Microsurgery Department, Policlinico GB Rossi, Azienda Ospedaliera Universitaria Verona, Verona, Italy.
• J Orthop Trauma. 2013 Dec 1;27(12):740-5.

ObjectivesDetermining the rate of specific adverse events after volar plating performed for distal radius fractures.DesignRetrospective.SettingUniversity level I trauma center.PatientsWe searched the electronic database of all surgical procedures performed in our department using the following keywords: distal radius fracture, wrist fracture, and plate fixation. We identified 315 patients, 12 of whom were lost at follow-up.InterventionVolar plate fixation for the treatment of distal radius fractures.Main Outcome MeasurementsAt an average follow-up of 5 years, 303 patients were evaluated through medical records and clinical and radiographic assessment for specific adverse events after volar plate fixation.ResultsAdverse events were observed in 18 patients (5.9%). Implant-related adverse events, including tendon impairments, intra-articular screws, and screw loosening, were observed in 15 patients (5.0%). Extensor tendon impairments were represented by 5 cases of extensor tenosynovitis and 3 cases of rupture of the extensor pollicis longus due to screws protruding dorsally. Flexor impairments were represented by 2 cases of tenosynovitis and 2 cases of flexor pollicis longus rupture. Screw penetration into the radioulnar joint was observed in 1 case. Loss of reduction was identified in 3 cases. One patient had a deep postoperative infection treated with operative debridement. One patient experienced injury to the median nerve during routine implant removal unrelated to tendon issues.ConclusionsThe majority of adverse events after volar plate fixation were due to technical errors in implant placement. In our cohort, tendon impairments were the most frequently observed; among these, extensor tendon impairments were the most represented (50% of all adverse events). All 12 tendon-related adverse events were due to technical shortcomings with implant placement.Level Of EvidenceTherapeutic level IV.

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