Failure of VariAx® Distal Radial Locking Plate: Fractographic Analysis and Report of Two Cases

We describe two cases of atraumatic fracture of VariAx® distal radial locking plate following its use in distal radial osteotomies. The plates fractured through an unused screw hole at the level of the osteotomy. Scanning electron microscopy was used to evaluate the fracture surfaces. This confirmed that there had been fatigue failure and did not find evidence of abnormal composition or structure of the metal. These cases are important because they highlight that this new and innovative implant can be prone to failure, and demonstrate the requirement for adequate surgical technique and metalwork protection following surgery.