Abstract
Purpose: Distal radius fractures are commonly treated with volar plate fixation, which can cause flexor tendon irritation. However, the effect of plate position on pinch and grip strengths has not been thoroughly studied. The aim of this study was to investigate the effect of plate position on grip and pinch strength in patients who underwent volar plate fixation.
Methods: We evaluated 40 patients who underwent volar locking plate fixation for distal radius fracture between 2018 and 2023. Patients were divided into three groups based on the Soong classification. We compared the modified Mayo wrist score, pinch and grip strengths between the affected and contrlateral normal extremities, and wrist range of motion at the last follow-up visits.
Results: Of the 40 patients evaluated, 32 were included in the study: 10 were in grade 0 group (Soong grade 0), 11 in grade 1 group (Soong grade 1), and 11 in grade 2 group (Soong grade 2). Significant differences in modified Mayo wrist scores were found between grade 0 and 2 groups and between grade 1 and 2 groups. When comparing pinch strengths of all groups, grade 0 group had significantly better pinch strength than grade 1 and 2 groups. Regarding grip strengths, grade 0 group had a significantly better pinch strength than grade 2 group.
Conclusions: Plate location can affect grip and pinch strength in patients undergoing volar plate fixation for distal radius fracture due to flexor tendon irritation. Patients with no increase in pinch strength in the postoperative period should be evaluated using ultrasonography (USG) for tendon irritation, and early implant removal should be considered if necessary.

Key words: Distal radius fracture; volar locking plate fixation; flexor tendon irritation; pincer strength; grip strength.