# The Effect of Proximal Cortical Screw Length of Volar Locking Plates on Clinical Outcomes in Distal Radius Fractures

## TL;DR

This study finds that the length of certain screws used in wrist fracture surgery affects postoperative complications like tendon irritation.

## Contribution

The study identifies a specific threshold (1.2 mm) for proximal screw protrusion linked to extensor tenosynovitis in wrist fracture patients.

## Key findings

- Proximal screw prominence over 1.2 mm was significantly associated with extensor tenosynovitis.
- Other clinical outcomes like grip strength and range of motion were not linked to screw length.
- 22 patients experienced extensor tenosynovitis due to screw length.

## Abstract

Objective

The aim of this study is to examine whether the length of the proximal diaphyseal screws of volar locking plates used in distal radius fractures affects the clinical outcomes.

Material and methods

The study included patients who were over 18 years of age and underwent volar locking plate application due to distal radius fracture with a minimum follow-up period of 12 months. Demographic data, Quick Disabilities of the Arm, Shoulder, and Hand (QDASH), grip strength, range of motion, and extensor tendon irritations were evaluated in patients. The prominence of the proximal cortical screws of the plates from the dorsal cortex was measured (in mm) on the lateral radiographs of the patients.

Results

The median follow-up time of the 73 patients in our study was 17 (14-26) months. The median age of the patients was 51 (44-58) years. Extensor tenosynovitis was detected in 22 patients due to proximal screw length. Proximal screw prominence over 1.2 mm was found to be statistically significant for extensor synovitis (p<0.05). Range of motion, radiological measurements, grip strength, QDASH, and other demographic data had no association with extensor tenosynovitis.

Conclusion

In the surgical treatment of distal radius fractures, dorsal cortex protrusion of proximal cortical screws of volar locking plates more than 1.2 mm plays a role in postoperative patient dissatisfaction.