Complications and risk factors following volar locking plate fixation of distal radius fractures: A 2-institution retrospective study.

Authors

Xiong Zhang, Xiaocong Zhou, Weijiang Bai, Yongliang Liu, Lingde Kong, Bing Zhang

Published in

Medicine. Volume 105. Issue 29. Pages e49794. Jul 17, 2026.

Abstract

Distal radius fractures are among the most common skeletal injuries and are increasingly treated with volar locking plate (VLP) fixation. Despite its widespread use, postoperative complications remain a significant concern. This study aimed to determine the incidence and spectrum of complications following VLP fixation and to identify independent predictors in a 2-institution cohort. Adult patients who underwent VLP fixation for acute distal radius fractures at 2 tertiary centers between January 2022 and June 2024 were retrospectively reviewed. Inclusion criteria involved operation within 3 weeks of injury and at least 12 months of follow-up. Demographic, clinical, fracture-related, perioperative, and surgeon-related variables were collected from electronic medical records. Complications were defined using standardized criteria and classified as major (requiring reoperation/implant removal) or minor (managed conservatively). Risk factors were evaluated using univariate and multivariate logistic regression. Of 1147 screened patients, 924 met eligibility criteria. Complications occurred in 116 patients (12.6%), comprising 145 events, with 3.6% major and 9.0% minor complications. The most common events were wound problems (21.9%), carpal tunnel syndrome (15.1%), and tendon irritation/rupture (12.3%). Independent predictors included chronic obstructive pulmonary disease (odds ratio [OR]: 2.25, 95% confidence interval [CI]: 1.12-5.62), osteoporosis (OR: 2.03, 95% CI: 1.68-2.43), Association for the Study of Internal Fixation type C fractures versus type A (OR: 1.97, 95% CI: 1.48-2.65), lunate facet collapse ≥5 mm (OR: 3.29, 95% CI: 1.26-7.91), and increased intraoperative blood loss (per 10-mL increment, OR: 1.12, 95% CI: 1.04-1.22). Our findings demonstrate that comorbidities, fracture complexity, and intraoperative factors independently increase complication risk. Individualized perioperative care and meticulous surgical planning may reduce morbidity and improve outcomes in high-risk patients.

PMID:
42470049
Bibliographic data and abstract were imported from PubMed on 18 Jul 2026.

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