Abstract
Purpose
The purpose was to determine the incidence of volar shear distal radius fractures
at a level 1 trauma center and identify risk factors for this fracture pattern.
Materials and Methods
A retrospective review of all patients who presented to a level 1 trauma center with
a distal radius fracture over a 2-year span was performed. Volar shear distal radius
fractures can be characterized into two distinct types, partial articular and complete
articular. A total of 35 patients with partial articular or complete articular volar
shear distal radius fractures were compared with 377 patients who had other types
of distal radius fractures. In a second analysis, 17 patients with partial articular
volar shear distal radius fractures (AO Type B3) were compared with 395 patients who
had other types of distal radius fractures (AO Types A, B1/2, and C). The cohorts
were compared for differences in patient demographics and injury mechanism. A multivariate
analysis identified significant risk factors for partial articular volar shear distal
radius fractures.
Results
The incidence of volar shear distal radius fractures was 8.5% (35/412). Patients with
volar shear distal radius fractures were younger (40.1 versus 51.5 years, p = 0.003) than patients with other types of distal radius fractures. A high energy
mechanism of injury (OR = 5.4, p = 0.0001) and male sex (OR = 3.0, p = 0.003) were significant risk factors for volar shear distal radius fractures. In
a subgroup analysis of partial articular volar shear distal radius fractures, younger
age, high energy mechanism of injury, and male sex were found to be significant risk
factors. In a multivariate analysis, high energy mechanism of injury and younger age
remained significant risk factors for partial articular volar shear distal radius
fractures.
Conclusion
High energy mechanisms of injury and younger age are significant risk factors for
volar shear distal radius fractures.
Level of Evidence
Level III, Case Control Study.
Keywords
AO classification - distal radius fracture pattern - risk factor - volar Barton fracture
- volar shear distal radius fracture
