Comparative study on the treatment of unstable distal radius fractures: variable-angle volar locking plate versus non-locking volar distal radius plate

Background: Distal end radius fractures constitute 10% of all human skeletal fractures. Such fractures mainly affect the elderly population and they involve low energy trauma. The purpose of this study was to evaluate the use of variable angle locking plate versus non locking volar plate for the management of unstable distal end radius fractures. Methods: In our study there were 20 patients with unstable distal end radius fractures who underwent ORIF using variable angle locking plate (10 patients) and Non locking plate (10 patients). Patients aged between 23 and 62 years old with mean age 39.50±14.24 for variable angle plate and 38.70±12.76 for Non locking volar plate. 15 patients were males (8 operated by variable angle plate and 7 operated by non locking plate) while 5 were female (2 opertaed by variable angle palate and 3 operated by non locking  plate). Results: The functional results were assessed according to Quick DASH score. For variable angle plate group: 6 patients (60%) had excellent results (scores between 0 to 11), 3 patients (30%) had good results (scores between 12-22) and only one patient (10%) had fair results (scores between 23-33), no patients had poor results with a mean DASH score of 14.5. For Non locking plate group: 3 patients (30%) had excellent results, 6 patients (60%) had good results and only one patient (10%) had fair results, no patients had poor results with a mean DASH of 15.9 .  Radiological results were evaluated according to Castaign radiological assessment score. For Variable angle plate group: 6 patients (60%) had excellent results (scores between7-8), 4 patients (40%) had good results (scores between5-6) and no patients had fair or poor results. The score ranged from 5 to 8 in the studied patients’ group with a mean of (6.8). For Non locking plate group: 2 patients (20%) had excellent results (scores between7-8), 7 patients (70%) had good results (scores between5-6) and 1 patient (10%) had fair results (scores between3-4), no patients had poor results. The score ranged from 4 to 8 in the studied patients’ group with a mean of (6). Conclusion: Variable angle volar locking plate and Non Locking volar plate both are effective tools for management of unstable fracture of distal end radius however Variable angle plate achieves more satisfactory results in complex articular fractures.