Volar locking plate (VLP) versus non-locking plate (NLP) in the treatment of die-punch fractures of the distal radius, an observational study

Abstract Purpose This study aims to evaluate whether volar locking plate was superior over non-locking plate in the treatment of die-punch fractures of the distal radius. Methods A total of 57 patients with closed die-punch fractures of the distal radius were included and analyzed. Of them, 32 were treated by non-locking plate (NLP) and the remaining 25 were treated by volar locking plate (VLP). Preoperative radiographs, computer tomographs and three-dimensional reconstruction, radiographs taken at immediate postoperation and at last follow-up were extracted and evaluated. Patients' electronic medical records were inquired and related demographic and medical data were documented. The documented contents were volar tilt, radial inclination, ulnar variance, grip strength, Disabilities of the Arm, Shoulder, and Hand (DASH) and visual analog scale (VAS) scores and complications. Results VLP group demonstrated a significantly reduced radial subsidence of 1.5 mm (0.7 versus 2.2 mm), during the interval of bony union (P  Conclusions VLP leaded to significantly better results of reduction maintainance and the final joint congruity than NLP, while reducing overall and major complications. However, the results should be treated in the context of limitations and the clinical significance of the difference required further studies to investigate.