Functional outcomes and complication patterns in adult distal radius fractures managed with volar locking plates: A prospective hospital-based observational study.

Dr Devireddy   Venkatreddy; Dr Venugopal  Palakurthi; Dr. Kanukurthi   Kiran; Dr. Kishore Kumar  Nagabandi

doi:10.51168/sjhrafrica.v6i12.2291

Authors

Dr. Devireddy Venkatreddy Assistant Professor, Department of Orthopaedics, Government Medical College, Nagarkurnool, Telangana, India
Dr. Venugopal Palakurthi Professor, Department of Orthopaedics, Government Medical College, Quthbullapur, Telangana, India
Dr. Kanukurthi Kiran Assistant Professor, Department of Orthopaedics, Government Medical College, Yadadri Bhongir, Telangana, India
Dr. Kishore Kumar Nagabandi Assistant Professor, Department of Orthopaedics, Government Medical College, Quthbullapur, Telangana, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i12.2291

Keywords:

Distal radius fracture, Volar locking plate, Functional outcome, Modified Mayo Wrist Score, Fracture fixation, Postoperative complications

Abstract

Background
Distal radius fractures remain among the most frequent upper-limb injuries in adults. Volar locking plates have become a preferred treatment option due to their stable fixation and predictable functional recovery.

Aim: To assess functional outcomes and complication patterns in adults with distal radius fractures managed using volar locking plates.

Methods
This hospital-based observational study included 100 adult patients treated with volar locking plate fixation. Demographic features, fracture types, mechanism of injury, and operative details were recorded. Functional outcomes were assessed at 6 weeks, 3 months, and 6 months using the Modified Mayo Wrist Score (MMWS). Complications were documented throughout follow-up. Data were summarised using descriptive statistics.

Results
The mean age of participants was 44.6 ± 12.8 years, with a male predominance. Road-traffic accidents were the major cause of injury. AO Type C fractures formed the largest subgroup. Anatomical reduction was achieved in 90% of cases. Functional performance improved across follow-up, and 84% demonstrated excellent or good outcomes by 6 months. The mean final MMWS was 86.3 ± 9.4, reflecting favourable wrist function in most individuals. Complications occurred in 18% of patients. Transient median nerve neuropathy, superficial infection, tendon irritation, malunion, and implant loosening were the main issues; however, no case of tendon rupture or deep infection was recorded. Functional independence was regained by 92% at the end of follow-up.

Conclusion
Volar locking plate fixation offers stable anatomical restoration, reliable union, and robust functional recovery in distal radius fractures. The complication rate remained low, and most issues were manageable with timely intervention.

Recommendations
Future practice should incorporate early presentation, consistent radiographic monitoring, and structured physiotherapy to enhance long-term functional gains. Detailed preoperative planning is advisable for complex fractures to minimise malalignment. Strengthening postoperative surveillance can help detect implant-related issues early.

Author Biographies

Dr. Devireddy Venkatreddy , Assistant Professor, Department of Orthopaedics, Government Medical College, Nagarkurnool, Telangana, India

MBBS, MS (Orthopaedics), is an Assistant Professor in the Department of Orthopaedics at Government Medical College, Nagarkurnool, Telangana, India. He completed his MBBS followed by MS in Orthopaedics, establishing a strong foundation in trauma care, fracture management, and reconstructive orthopaedic procedures. His clinical work spans acute injury management, operative fixation techniques, and postoperative rehabilitation planning, with a consistent commitment to patient-centred care. He is actively engaged in undergraduate and postgraduate teaching, skill-based training, and academic mentoring within the department. His academic interests include upper-limb trauma, internal fixation methods, and outcome analysis in common orthopaedic conditions. He continues to contribute to institutional research and departmental quality-improvement activities, strengthening evidence-based orthopaedic practice.ORCID iD: https://orcid.org/0009-0002-5190-3368

Dr. Venugopal Palakurthi , Professor, Department of Orthopaedics, Government Medical College, Quthbullapur, Telangana, India

MBBS, MS (Orthopaedics), is Professor of Orthopaedics at Government Medical College, Quthbullapur, Telangana, India. With extensive experience in trauma surgery, arthroplasty, and complex fracture management, he plays a pivotal role in guiding academic, clinical, and administrative functions within the department. He has mentored numerous residents, supervised research projects, and contributed to orthopaedic skill development across successive training batches. His professional interests include optimising surgical outcomes, enhancing orthopaedic education, and strengthening clinical protocols in high-volume government hospitals. He continues to advance patient care through a combination of disciplined surgical expertise and a strong commitment to medical teaching.ORCID iD: https://orcid.org/0009-0005-5566-3535

Dr. Kanukurthi Kiran , Assistant Professor, Department of Orthopaedics, Government Medical College, Yadadri Bhongir, Telangana, India

MBBS, MS(Orthopaedics), serves as an Assistant Professor in the Department of Orthopaedics at Government Medical College, Yadadri Bhongir, Telangana, India. His clinical work focuses on the management of trauma, fracture fixation, and orthopaedic emergency care, with a growing interest in minimally invasive surgical techniques. He is actively involved in undergraduate and postgraduate teaching, contributing to skill development and evidence-based orthopaedic training. His academic engagement includes participation in departmental research and initiatives aimed at improving patient outcomes. ORCID iD: https://orcid.org/0009-0005-1106-9948

Dr. Kishore Kumar Nagabandi, Assistant Professor, Department of Orthopaedics, Government Medical College, Quthbullapur, Telangana, India

MBBS, MS (Orthopaedics), is an Assistant Professor in the Department of Orthopaedics at Government Medical College, Quthbullapur, Telangana, India. His clinical interests include the management of musculoskeletal trauma, intertrochanteric fractures, and lower-limb reconstruction procedures. He is actively engaged in academic teaching and skill-based training for medical undergraduates, while also contributing to departmental research activities. His work emphasises evidence-based orthopaedic practice and improving functional outcomes through meticulous surgical technique and structured postoperative care.ORCID iD: https://orcid.org/0000-0002-9493-4319

References

MacFarlane RJ, Miller D, Wilson L, Meyer C, Kerin C, Ford DJ, Cheung G. Functional Outcome and Complications at 2.5 Years Following Volar Locking Plate Fixation of Distal Radius Fractures. J Hand Microsurg. 2015 Jun;7(1):18-24. https://doi.org/10.1007/s12593-014-0155-1 PMid:26078498 PMCid:PMC4461642

Thusoo V, Chakrapani AS, Nehru A, Kudyar S, Nagpal B, Kv A, S E, Jose A. Functional Outcomes in the Distal End of Radius Fracture: A Prospective Study in a Tertiary Care Center. Cureus. 2024 Nov 22;16(11):e74226. doi: 10.7759/cureus.74226. PMID: 39712799; PMCID: PMC11663396.

Pacchiarini L, Massimo Oldrini L, Feltri P, Lucchina S, Filardo G, Candrian C. Complications after volar plate synthesis for distal radius fractures. EFORT Open Rev. 2024 Jun 3;9(6):567-580. https://doi.org/10.1530/EOR-23-0188

PMid:38828969 PMCid: PMC11195338

Wreto L, Fornander L. Long-term outcome for patients with distal radius fractures treated with volar locking plates versus percutaneous wires. PLoS One. 2024 Nov 12;19(11):e0307763https://doi.org/10.1371/journal.pone.0307763

PMid:39531478 PMCid: PMC11556730

Huang YM, Chen CY, Lin KC, Tarng YW, Liao CY, Chang WN. Functional outcomes following fixation of a marginal distal radius fracture with two commonly used volar locking plates: a retrospective cohort study. BMC Musculoskelet Disord. 2022 Jan 3;23(1):18. https://doi.org/10.1186/s12891-021-04984-1 PMid:34980102 PMCid:PMC8725281

Rozental TD, Blazar PE. Functional outcome and complications after volar plating for dorsally displaced, unstable fractures of the distal radius. J Hand Surg Am. 2006 Mar;31(3):359-65. https://doi.org/10.1016/j.jhsa.2005.10.010 PMid:16516728

Chung KC, Squitieri L, Kim HM. Comparative outcomes study using the volar locking plating system for distal radius fractures in both young adults and adults older than 60 years. J Hand Surg Am. 2008 Jul-Aug;33(6):809-19.

https://doi.org/10.1016/j.jhsa.2008.02.016 PMid:18656749 PMCid:PMC4386628

Patel S, Deshmukh A, Yadav P, Phalak M, Gurnani S, Yadav S, Anand A. Assessment of Functional and Radiological Outcomes of Comminuted Intra-Articular Distal Radius Fracture Treated With Locking Compression Plate. Cureus. 2022 Jan 19;14(1):e21398. https://doi: 10.7759/cureus.21398 PMID: 35198305; PMCID: PMC8855141.

Dondapati A, Pandian H, Mohideen S, Pradeep E, Kumar KVA, Balamurugan P. Functional Outcome of Distal Radius Fractures Managed by Minimally Invasive Plate Osteosynthesis: A Prospective Study of 20 Patients. J Orthop Case Rep. 2025 May;15(5):269-273. https://doi.org/10.13107/jocr.2025.v15.i05.5630 PMid:40351646 PMCid:PMC12064226

Alter TH, Sandrowski K, Gallant G, Kwok M, Ilyas AM. Complications of Volar Plating of Distal Radius Fractures: A Systematic Review. J Wrist Surg. 2019 Jun;8(3):255-262. https://doi.org/10.1055/s-0038-1667304 PMid:31192050 PMCid:PMC6546498

Shen O, Chen CT, Jupiter JB, Chen NC, Liu WC. Functional outcomes and complications after treatment of distal radius fracture in patients sixty years and over: A systematic review and network meta-analysis. Injury. 2023 Jul;54(7):110767. https://doi.org/10.1016/j.injury.2023.04.054 PMid:37188586

Latypov N, Golubev I, Borisova A. Volar Locking Plate versus Closed Reduction and Immobilization for Distal Radius Fracture in the Elderly: Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Wrist Surg. 2023 Nov 7;13(6):559-571. https://doi.org/10.1055/s-0043-1774331 PMid:39619453 PMCid: PMC11606675