Arch Hand Microsurg 2019; 24(1): 24-31  
The Effect of Volar Locking Plate Leveraging on Restoring Volar Tilt of Distal Radius Fractures
Han-Vit Kang1, Jin-Hyung Im3, Jae-Hoon Choi4, Joon-Hyuck Oh1, Soo-Hwan Kang1, Joo-Yup Lee2
1Department of Orthopedic Surgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea, 2Department of Orthopedic Surgery, St. Paul’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, 3Orthopedic Surgery, Hand and Microsurgery Department, Gyeongsang National University Changwon Hospital, Changwon, Korea, 4Department of Orthopedic Surgery, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
Correspondence to: Joo-Yup Lee
Department of Orthopedic Surgery, St. Paul’s Hospital, College of Medicine, The Catholic University of Korea, 180 Wangsan-ro, Dongdaemungu, Seoul 02559, Korea
TEL: +82-2-960-4532, FAX: +82-2-965-1456, E-mail: jylos1@gmail.com
Received: December 12, 2018; Revised: January 5, 2019; Accepted: January 9, 2019; Published online: March 1, 2019.
© Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: The purpose of the study was to analyze the radiologic and clinical outcomes of volar locking plate leveraging technique comparing to conventional technique and to prove the effect of volar locking plate leveraging technique on restoring volar tilt of distal radius fractures.
Methods: From January 2011 to December 2015, 196 patients (50 males and 146 females) who underwent operative treatment of distal radius fracture met the inclusion criteria and retrospectively analyzed. We defined group 1 (n=93, 23 males and 70 females) as patients who were operated by conventional method, and group 2 (n=103, 27 male and 76 females) as patients who were operated by volar locking plate leveraging technique. Postoperative radiographic parameters including radial inclination, radial length, and volar tilt were measured as radiologic outcomes and range of motion, pain visual analogue scale, grip strength, shortened disabilities of arm, shoulder and hand questionnaire were measured as clinical outcomes.
Results: Postoperative radial inclination, radial length, and volar tilt in group 1 was 24.22°, 12.02 mm, and 9.31°, in group 2 was 25.64°, 12.40 mm, and 11.48°. There was statistically significant difference in postoperative volar tilt (p=0.008). There were no statistic differences in other radiologic parameters and clinical outcomes.
Conclusion: Volar locking plate leveraging technique is reliable and predictable technique for restoration of anatomical parameters of distal radius fracture, especially volar tilt.
Keywords: Distal radius fracture, Volar tilt, Reduction technique, Plate leverage, Volar locking plate


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