BACKGROUND: Volar plating of unstable distal radius fractures (DRF) has become 
the favoured treatment. The complication rates vary from 3 to 36%. The purpose 
of the study was to estimate the complication rate of volar plating of DRF and 
its association with AO/OTA fracture type, surgeon experience and type of volar 
plate.
METHODS: Retrospectively, all patients treated with volar plating of a DRF 
between February 2009 and June 2013 at Aarhus University Hospital, Denmark were 
included. AO/OTA fracture type, surgeon experience (1st year, 2nd-5th year 
resident or consultant), type of plate (VariAx®, Acu-Loc®) and complications 
were extracted from the electronic medical records. Complications were 
categorized as carpal tunnel syndrome, other sensibility issues, tendon 
complications including irritation and rupture, deep infections, complex 
regional pain syndrome and unidentified DRUJ or scapholunar problems. 
Reoperations including hardware removal were also charted.
RESULTS: 576 patients with a median age of 63 years (min: 15; max: 87) were 
included. 78% were female and the mean observation time was 3.2 years (min: 2.0; 
max: 5.4). 78% (n=451) of the patients were treated with VariAx® and 22% (n=125) 
with Acu-Loc®. The overall complication rate was 14.6% (95% CI 11.8-17.7) 
including carpal tunnel syndrome or change in sensibility in 5.2% and tendon 
complications in 4.7%. Five flexor tendon ruptures and 12 extensor tendon 
ruptures were observed. The reoperation rate was 10.4% including 41 cases of 
hardware removal. A statistically significant association between AO/OTA 
fracture type C and complications was found. No statistically significant 
association between complication rate and surgeon experience and type of plate 
was observed.
CONCLUSION: The majority of DRF patients treated with a volar plate suffer no 
complications. However, the overall complication rate of 14.6% is substantial. 
Intra-articular fractures, e.g. AO/OTA-type 23C1-3, had significantly higher 
complication rates. Neither surgeon experience, nor type of volar plate was able 
to predict complications.