Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Orthopedic Surgery

The aim of treatment is a wrist with adequate pain-free motion and stability allowing daily activities, with no obvious deformity, without future degenerative changes.The use of volar locked plate for most of varieties of distal radial fractures had proved its efficacy in achieving good functional results, with less time of immobilization and early rehabilitation which was believed economically and socially better than the other treatment modalities as cast, pinning, external fixators, conventional plating. However some cases required the addition of K- wires, dorsal, or fragment specific plates for better results.Biomechanically, the volar locked plate provided the solution to the challenge of distal fragment fixation as these implants did not require screw purchase into the distal fragment and therefore were less likely to loosen and toggle. They functioned as internal-external fixators avoiding disadvantages of external fixators, and also as nails, giving support by interference fit. Biologically, volar locked plate with their reliance on the tough subchondral bone support had offered a valuable solution in management of insufficiency fractures of distal radius in elderly population due to osteoporosis, which are characterized by compression failure of metaphyseal bone with defect and severe comminution

Issued also as CD