Do angle stable implants provide advantages? Treatment of distal radius fractures with the locking compression plate (LCP)

Can distal radius fractures be held in place with palmar locking compression plates (LCPs) and heal completely without an additional bone transplant? From 1 March 2001 to 1 September 2002, 40 patients with distal radius fractures (CCF: 2× A2, 13× A3, 2× C1, 22× C2 and 1× C3 fractures) were treated with locking compression small fragment titanium plates. In 37 cases, the plates were inserted in a palmar direction without an additional corticocancellous bone graft. All patients received a follow-up check-up after an average of 12.1 months. On this occasion, the range of motion, grip strength and radiological result were measured and rated according to the Gartland and DASH score. All fractures healed completely. In one case, a re-osteosynthesis was carried out after the plate had bent because full load was placed on it prematurely. An average of 5.1 points was achieved in the Gartland and 12.6 points in the DASH score. An extremely good result was achieved in 19 cases, a good result in 15 and a satisfactory result in 6. At the follow-up examination, the average range of motion was 52°-0°-50° for stretching and bending in the wrist, 20°-0°-27° for radial and ulnar deviation and 82°-0°-78° for pronation and supination. On the radiographs, the average radiocarpal angle in the anteroposterior projection was 22° with a palmar tilt of an average of 5°. Radius fractures with metaphyseal, one-sided comminuted zones can be treated with locking compression plates with good results using a palmar approach without a cancellous bone graft.