Clinical Outcomes of AO/OTA Type C Distal Radius Fractures Treated With Volar Locking Plate Versus Fragment-Specific Plating.

Purpose: Distal radius fractures remain one of the most common adult fractures, with increasing operative fixation rates. Volar locking plates (VLPs) have been widely used because of their low complication rates and straightforward approach. Fragment-specific fixation (FSF) is often used for more complex fractures. Prior comparative studies have been limited because of smaller cohorts. Methods: A retrospective multicenter review was performed on patients who underwent surgical fixation with either VLPs or FSF from January 2018 to June 2024. Demographic, operative, and postoperative data were collected. Analysis used Results: In total, 211 patients were included: 150 VLP and 61 FSF. The two groups were comparable in terms of demographics and comorbidities. The data set included individuals presenting with complete articular, type C, fractures in accordance with the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) classification system. Compared with the VLP group, FSF was associated with longer operative times (133 vs 94 minutes) and greater removal of hardware rates (19.7% vs 7.3%). Intraoperative complications, postoperative complications, 90-day emergency department visits, and readmissions were comparable between the groups. Conclusions: Fragment-specific fixation was associated with longer operative times and higher rates of reoperation for hardware removal but did not appear to increase rates of major adverse postoperative clinical outcomes when compared with VLP. Type of study/level of evidence: Therapeutic III.