{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T20:32:45Z","timestamp":1789590765420,"version":"build-2803163510"},"reference-count":28,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T00:00:00Z","timestamp":1684195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Background: Different distal radial fracture types have different prognosis after fixation. Our study aim is to evaluate the differences in radiographic parameters by using variable-angle volar locking plate (VAVLP) fixation according to extra-articular and intra-articular distal radial fracture. (2) Methods: There are two groups: extra-articular group (21) and intra-articular group (25). Forearm radiographs immediately after surgery and at 3 months after operation were reviewed for analyzing radial height (RH), ulnar variance (UV), radial inclination (RI), volar tilt (VT), tear drop angle (TDA), distal dorsal cortical distance (DDD), and Soong classification (SC). (3) Results: There were no significant differences in the above parameters between two groups at either immediately post-operative or at 3-month follow-up, except for TDA (p = 0.048). Most patients in both groups were at low risk of flexor tendon rupture, except for two cases. We observed a positive correlation between post-operative DDD and 3-month change in the intra-articular group, but not the extra-articular group. (4) Conclusions: Our study demonstrates that VAVLP fixation is effective in maintaining the stability of most radiographic parameters and reduces the risk of tendon rupture in both extra-articular and intra-articular distal radial fractures. Post-operative DDD can be used to predict the degree of subsequent displacement in patients with intra-articular fractures fixed with VAVLP.<\/jats:p>","DOI":"10.3390\/jcm12103494","type":"journal-article","created":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T01:58:06Z","timestamp":1684288686000},"page":"3494","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Radiographic Analysis in Extra-Articular and Intra-Articular Distal Radius Fractures Treated with Variable-Angle Volar Locking Plate Fixation"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3195-2755","authenticated-orcid":false,"given":"Pin-Chieh","family":"Fang","sequence":"first","affiliation":[{"name":"Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tak-Yu-Yubie","family":"Lo","sequence":"additional","affiliation":[{"name":"Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Ying","family":"Cheng","sequence":"additional","affiliation":[{"name":"Bone and Joint Research Center, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan"},{"name":"Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital-Taoyuan, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Te","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0111-490X","authenticated-orcid":false,"given":"Alvin Chao-Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Bone and Joint Research Center, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan"},{"name":"Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital-Taoyuan, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Jerrhag, D., Englund, M., Karlsson, M.K., and Rosengren, B.E. (2017). Epidemiology and Time Trends of Distal Forearm Fractures in Adults\u2014A Study of 11.2 Million Person-Years in Sweden. BMC Musculoskelet. Disord., 18.","DOI":"10.1186\/s12891-017-1596-z"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1302\/0301-620X.96B7.33149","article-title":"The Operative Treatment of Fractures of the Distal Radius Is Increasing: Results from a Nationwide Swedish Study","volume":"96-b","author":"Pettersson","year":"2014","journal-title":"Bone Jt. J."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Hevonkorpi, T.P., Launonen, A.P., Huttunen, T.T., Kannus, P., Niemi, S., and Mattila, V.M. (2018). Incidence of Distal Radius Fracture Surgery in Finns Aged 50 Years or More between 1998 and 2016\u2014Too Many Patients Are yet Operated On?. BMC Musculoskelet. Disord., 19.","DOI":"10.1186\/s12891-018-1983-0"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1007\/s00256-011-1355-4","article-title":"Radiological Dorsal Tilt Analysis of Ao Type a, B, and C Fractures of the Distal Radius Treated Conservatively or with Extra-Focal K-Wire Plus External Fixateur","volume":"41","author":"Hoffmann","year":"2012","journal-title":"Skelet. Radiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"28","DOI":"10.5435\/00124635-200501000-00005","article-title":"Volar Fixed-Angle Plating of the Distal Radius","volume":"13","author":"Smith","year":"2005","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_6","first-page":"e25174","article-title":"Surgical Treatment of Unstable Distal Radius Fractures with a Volar Variable-Angle Locking Plate: Clinical and Radiological Outcomes","volume":"5","author":"Khatri","year":"2016","journal-title":"Arch. Trauma Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1097\/SAP.0000000000000850","article-title":"Complication Rate Comparing Variable, Angle Distal Locking Plate to Fixed Angle Plate Fixation of Distal Radius Fractures","volume":"77","author":"Mehrzad","year":"2016","journal-title":"Ann. Plast. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2488","DOI":"10.1016\/j.jhsa.2012.09.009","article-title":"Biomechanical Analysis of a Volar Variable-Angle Locking Plate: The Effect of Capturing a Distal Radial Styloid Fragment","volume":"37","author":"Stanbury","year":"2012","journal-title":"J. Hand Surg. Am."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1097\/BOT.0000000000000146","article-title":"Can the Use of Variable-Angle Volar Locking Plates Compensate for Suboptimal Plate Positioning in Unstable Distal Radius Fractures? A Biomechanical Study","volume":"29","author":"Hart","year":"2015","journal-title":"J. Orthop. Trauma"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1007\/s00402-018-2925-x","article-title":"Comparison of Volarly and Dorsally Displaced Distal Radius Fracture Treated by Volar Locking Plate Fixation","volume":"138","author":"Erhart","year":"2018","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/S0363-5023(96)80006-2","article-title":"Classification of Distal Radius Fractures: An Analysis of Interobserver Reliability and Intraobserver Reproducibility","volume":"21","author":"Andersen","year":"1996","journal-title":"J. Hand Surg. Am."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1097\/00003086-200204000-00048","article-title":"Digital Radiographs in the Assessment of Distal Radius Fracture Parameters","volume":"397","author":"Bozentka","year":"2002","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1142\/S2424835522500461","article-title":"The Effect of Hand Dominance, Age, Gender, Fracture Comminution and Asa Status on Time to Fracture Healing Following Surgical Fixation of Distal Radius Fractures","volume":"27","author":"Tang","year":"2022","journal-title":"J. Hand Surg. Asian Pac. Vol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/S0363-5023(96)80151-1","article-title":"X-ray Film Measurements for Healed Distal Radius Fractures","volume":"21","author":"Kreder","year":"1996","journal-title":"J. Hand Surg. Am."},{"key":"ref_15","first-page":"308","article-title":"Measurement of Ulnar Variance and Radial Inclination on X-Rays of Healed Distal Radius Fractures. With the Axis of the Distal Radius or Ulna?","volume":"81","author":"Thuysbaert","year":"2015","journal-title":"Acta Orthop Belg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.hcl.2005.02.008","article-title":"Essential Radiographic Evaluation for Distal Radius Fractures","volume":"21","author":"Medoff","year":"2005","journal-title":"Hand Clin."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.jhsa.2011.10.056","article-title":"Reliability and Clinical Importance of Teardrop Angle Measurement in Intra-Articular Distal Radius Fracture","volume":"37","author":"Fujitani","year":"2012","journal-title":"J. Hand Surg. Am."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.ocl.2015.08.020","article-title":"Optimal Positioning for Volar Plate Fixation of a Distal Radius Fracture: Determining the Distal Dorsal Cortical Distance","volume":"47","author":"Vosbikian","year":"2016","journal-title":"Orthop. Clin. North. Am."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"328","DOI":"10.2106\/JBJS.J.00193","article-title":"Volar Locking Plate Implant Prominence and Flexor Tendon Rupture","volume":"93","author":"Soong","year":"2011","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_20","first-page":"e18321","article-title":"Early Results of a Variable-Angle Volar Locking Plate for Distal Radius Fractures: A Bi-Centre Study","volume":"13","author":"Elerian","year":"2021","journal-title":"Cureus"},{"key":"ref_21","first-page":"43","article-title":"Radiographic Analysis in Reduction Loss and Parameters Maintenance after Distal Radius Fracture Fixation with Variable-Angle Volar Locking Plate","volume":"12","author":"Fang","year":"2021","journal-title":"Formos. J. Musculoskelet. Disorders."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"131757","DOI":"10.1155\/2013\/131757","article-title":"Dorsally Comminuted Fractures of the Distal End of the Radius: Osteosynthesis with Volar Fixed Angle Locking Plates","volume":"2013","author":"Gogna","year":"2013","journal-title":"ISRN Orthop."},{"key":"ref_23","first-page":"6","article-title":"The Teardrop Angle and Ap Distance in Fractures of the Distal Radius","volume":"93-B","author":"Forward","year":"2011","journal-title":"Orthop. Proc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/j.jhsa.2014.11.022","article-title":"Incidence and Reasons for Hardware Removal Following Operative Fixation of Distal Radius Fractures","volume":"40","author":"Snoddy","year":"2015","journal-title":"J. Hand Surg. Am."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1177\/1753193419893561","article-title":"Impact of Soong Grading on Flexor Tendon Ruptures Following Palmar Plating for Distal Radial Fractures","volume":"45","author":"Sauerbier","year":"2020","journal-title":"J. Hand Surg. Eur. Vol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1177\/1753193417726636","article-title":"Relationship between Plate Removal and Soong Grading Following Surgery for Fractured Distal Radius","volume":"43","author":"Selles","year":"2018","journal-title":"J. Hand Surg. Eur. Vol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1055\/s-0040-1702931","article-title":"Evaluation of Flexor Pollicis Longus Tendon Rupture after Treatment of Distal Radius Fracture with the Volar Plate","volume":"9","author":"Yamak","year":"2020","journal-title":"J. Wrist Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/j.otsr.2018.04.009","article-title":"Double-Tiered Subchondral Support Fixation with Optimal Distal Dorsal Cortical Distance Using a Variable-Angle Volar Locking-Plate System for Distal Radius Fracture in the Elderly","volume":"104","author":"Lee","year":"2018","journal-title":"Orthop. Traumatol. Surg. 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