Incidence of Flexor Tendon Injuries in Complex Intra-Articular Distal Radius Fractures Fixed With Volar Rim Plate Osteosynthesis

AIM: The volar rim plate is anatomically contoured to provide buttressing of distal radius fragments including the lunate fossa. The low-profile design of the plate minimizes flexor tendon irritation. This study aims to determine the Disabilities of the Arm, Shoulder, and Hand (DASH) score and the presence of flexor tendon irritation at around one-year post operation.

METHOD: Between June 2020 and May 2021, all patients with AO-23B3 and AO-23C (1-3) distal radius fractures who were treated with a volar rim plate fixation were included in this study. At 12 months after surgery, the patients were evaluated utilizing DASH score as a routine as well as evidence of flexor tendon rupture or irritation.

RESULTS: Twenty-five patients were finally included in this study. Of these, three required additional dorsal plating for dorsal subluxation, four required fixation of ulna styloid with tension band wiring, and the rest (18) had volar rim plate fixation in isolation. The mean DASH score was 16.3. Two of the patients had flexor tendon irritations; one in the middle finger and another in the ring and little finger. None had flexor tendon rupture.

CONCLUSION: The volar rim plate is designed to tackle complex intra-articular distal fractures which are near the watershed line. There was no evidence of flexor tendon irritation on routine follow-up. The outcome was satisfactory in this small series despite the complexity of the fractures. Evidence of flexor tendon irritation requires prompt attention to enable early implant removal.