COMPLICATIONS WITH WRIST FIXATION USING DISTAL VOLAR RADIAL PLATES

Aim Fixation of distal radial fractures via the volar approach has become a commonly performed procedure over the past few years. This study is to highlight potential pitfalls with this ‘everyday’ procedure and to perhaps temper over-enthusiasm for plating all wrist fractures. Method and materials 164 consecutive cases of wrist fracture treated by means of fixed angle volar fixation were looked at. In each case any recorded complication prior to completion of treatment was documented. The complications were divided into major and minor depending on the severity and long-term outcome and overall result. Results With critical analysis there were 32 major complications: 12 required further surgery; 1 iatrogenic radial artery injury; 1 iatrogenic palmar branch of median nerve injury; 2 complex regional pain syndromes; 16 patients with less than 60 arc of movement. In addition 12 minor complications including hypertrophic scars, suture abscess and intermittent minor discomfort were also recorded. Conclusion While volar distal radial fixation is well accepted and indeed commonly performed, the procedure is not without complications. We must pay meticulous attention to detail and technique to optimise results.