Analysis of the Radiological Outcomes According to the Locking Mechanism of the Volar Plate in Distal Radius Fracture
Abstract Introduction: Volar plate fixation (VPF) is recommended as a useful surgical method for distal radius fracture (DRF), and locking screw fixation in the distal fragments is important to maintain reduction. Conventional locking mechanism with Point Contact Fixator (PC-Fix) system has been commonly used in VPF for DRF, and the TriLock mechanism recently became popular. However, there have been no studies comparing the radiological outcome of conventional locking mechanism and the TriLock mechanism. The purpose of our study was to analyze radiological outcomes according to the different locking mechanisms of the volar plate in DRF. Materials and methods: Retrospective comparative analysis was performed on 56 study and 74 control DRF patients treated with VPF between January 2019 to December 2020. TriLock mechanism was applied to all patients in the study group, and conventional locking mechanism was applied to all patients in the control group. Fracture characteristics, radiologic parameters, postoperative complications such as loss of reduction, hardware-related problems (screw perforation, screw loosening or backing out, plate breakage), and other general medical complications were collected and analyzed. Results: All patients obtained bony union within 3 months. There were no significant difference of age, sex between study and control group. 7 patients had loss of reduction in study group, and 2 patients had reduction loss in control group. Occurrence of the loss of reduction was associated with age (p = 0.022) and TriLock mechanism (p = 0.012). There were no significant hardware-related or other general problems in both groups. Conclusion: There were significantly more loss of reduction with metal failure in DFR treated Trilock locking technology than conventional locking technology. Further studies are needed to evaluate safety and efficacy of the TriLock locking technology.