Fitting anatomical plates in teenagers with displaced distal radius fractures: A retrospective review

Background

Distal radius fractures are the most common fractures among adolescents and young adults. In addition to Kirschner wires, after growth plate closure anatomical volar or dorsal radius plates may also be used for fixation. Current volar plates have been designed to fit the wrist of an average adult patient. The aim of this article was to review the use and the suitability of anatomical plates in the treatment of teenagers.

Methods

Retrospective data from patient records was collected on 59 patients, aged from 13 to 19 years, who underwent a plate fixation of distal radius at a tertiary center (level one university trauma hospital). An anatomical plate had been used in 32/59 (54.2%) of the patients. We reviewed and analyzed patient characteristics, injury mechanisms and types, post-operative complication, and pre- and post-operative radiological parameters.

Results

29 wrists were operated using volar and 3 using a dorsal anatomical plate. Anatomical plates had not been used in patients aged ≤14 years. Out of the 29 cases, in 17 (58.6%) wrists the plate positioning corresponded to Soong gr II. In our follow-up period, the incidence of the post-operative complications was not greater than reported among adults. The plate was removed post-operatively in two cases. One removal was done due to inadequate plate positioning causing tendon irritation, and the other due to superficial wound infection.

Conclusions

Kirschner wires should be considered the first line of treatment when operating distal radius fractures in teenagers. Hardware protrusion seems to be common when anatomical volar plates are used. Further research is required to assess the long-term safety and the cumulative rate of complications from the use of anatomical volar plates in teenagers.