scholarly journals Complication rates and reduction potential of palmar versus dorsal locking plate osteosynthesis for the treatment of distal radius fractures

2014 ◽  
Vol 15 (4) ◽  
pp. 259-264 ◽  
Author(s):  
F. Wichlas ◽  
N. P. Haas ◽  
A. Disch ◽  
D. Machó ◽  
S. Tsitsilonis
Keyword(s):  
Distal Radius ◽  
Reduction Potential ◽  
Locking Plate ◽  
Plate Osteosynthesis ◽  
Distal Radius Fractures ◽  
Complication Rates ◽  
Radius Fractures ◽  
Locking Plate Osteosynthesis

scholarly journals Management of Intra-Articular Distal Radius Fractures: Volar or Dorsal Locking Plate—Which Has Fewer Complications?

Hand ◽  
2016 ◽  
Vol 12 (6) ◽  
pp. 561-567 ◽  
Author(s):  
Yoshihiro Abe ◽  
Susumu Tokunaga ◽  
Takuro Moriya
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Clinical Results ◽  
Distal Radius Fractures ◽  
Complication Rates ◽  
Radius Fractures ◽  
Volar Approach ◽  
Pathologic Fractures ◽  
Dorsal Plating ◽  
Plate System

Background: The aim of this study was to compare the functional outcomes and complications of volar and dorsal plating for the management of intra-articular distal radius fractures, with special regard to indications for dorsal plating. Furthermore, we examine the rationale for choosing dorsal plating and its frequency of use. Methods: Clinical assessments included range of motion measurements at the wrist; grip strength; the Quick Disabilities of the Arm, Shoulder, and Hand score; and the Gartland and Werley score. Clinical results were compared with those achieved using a volarly placed locking plate system. According to Lutsky’s plate theory, the rationale for choosing dorsal plating was based on 4 types of pathologic fractures. Results: Of 112 patients, 38 patients were treated with open reduction internal fixation via a dorsal approach and 68 patients were treated using a volar approach. Except for wrist flexion, there were no other statistical differences in the clinical results between groups for both subjective and objective parameters. There were no statistically significant differences in the complication rates between the volar and dorsal plated groups. One serious complication occurred after volar plating. The most common reason for choosing dorsal plating was irreducible dorsal die-punch fractures. Conclusions: The treatment of displaced intra-articular distal radius fractures with a dorsally versus a volarly placed interlocking plate system demonstrated similar clinical results. Postoperative complications were not readily observed in the patients treated with a dorsal locking plate. Certain fracture patterns are more appropriately stabilized using a dorsal plate fixation.

scholarly journals COMPARATIVE STUDY EVALUATING OUTCOMES OF CONSERVATIVE VERSUS VOLAR LOCKING PLATE OSTEOSYNTHESIS FOR UNSTABLE DISTAL RADIUS FRACTURES

2020 ◽  
pp. 9-11
Author(s):  
Abhimanyu Kakralia ◽  
Zakir Hussain ◽  
Amit Jain ◽  
R.C. Meena
Keyword(s):  
Comparative Study ◽  
Distal Radius ◽  
Locking Plate ◽  
Plate Osteosynthesis ◽  
Functional Results ◽  
Distal Radius Fractures ◽  
Volar Locking Plate ◽  
Radius Fractures ◽  
Conservative Group ◽  
Prospective Comparative Study

Background: The objective of the study was to compare the results of conservative management and volar locking plate by assessing the functional and radiological parameters using Stewart et al. system (1) and Sarmiento’s modification of Gartland and Werley scores (2) respectively in cases of unstable distal radius fractures. Materials & Methods: This was a prospective comparative study, which included 50 cases of distal radius fractures with 32 cases in the conservative group and 18 cases in the operative group. Radiographic and functional outcomes were assessed at 2 weeks, 3 months and 6 months using Stewart et al. system and Sarmiento’s modification of Gartland and Werley scores respectively. Results: In operative group, radiological results were well to excellent results in 100% of the patients while in conservative group, 30% had excellent results, 17% had good results and 53% had fair result. At 6 months after surgery, functional results in both groups were improved. In operative group, 100% had excellent results while in conservative group 48% had excellent, 44.44% had good, and 7% had fair results. Conclusion: This study shows that volar locking plates evidently has better results in terms of achieved faster and accelerated functional recovery.

scholarly journals Comparison of a ceiling-mounted 3D flat panel detector vs. conventional intraoperative 2D fluoroscopy in plate osteosynthesis of distal radius fractures with volar locking plate systems

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Raphael Seuthe ◽  
Andreas Seekamp ◽  
Bodo Kurz ◽  
Julian Pfarr ◽  
Jost Philipp Schaefer ◽  
...  
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Plate Osteosynthesis ◽  
Distal Radius Fractures ◽  
Fracture Reduction ◽  
Volar Locking Plate ◽  
Radius Fractures ◽  
Flat Panel ◽  
Flat Panel Detector

Abstract Objectives To compare intraoperative 3D fluoroscopy with a ceiling-mounted flat panel detector in plate osteosynthesis of distal radius fractures (AO/OTA 2R3C1.2) with volar locking plate systems to conventional 2D fluoroscopy for detection of insufficient fracture reduction, plate misplacement and protruding screws. Methods Using a common volar approach on 12 cadaver forearms, total intraarticular distal radius fractures were induced, manually reduced and internally fixated with a 2.4 distal radius locking compression plate. 2D (anterior-posterior and lateral) and 3D (rotational) fluoroscopic images were taken as well as computed tomographies. Fluoroscopic images, Cone Beam CT (CBCT), 360° rotating sequences (so called “Movies”) and CT scans were co-evaluated by a specialist orthopedic surgeon and a specialist radiologist regarding quality of fracture reduction, position of plate, position of the three distal locking screws and position of the three diaphyseal screws. In reference to gold standard CT, sensitivity and specifity were analyzed. Results “Movie” showed highest sensitivity for detection of insufficient fracture reduction (88%). Sensitivity for detection of incorrect position of plate was 100% for CBCT and 90% for “Movie.” For intraarticular position of screws, 2D fluoroscopy and CBCT showed highest sensitivity and specifity (100 and 91%, respectively). Regarding detection of only marginal intraarticular position of screws, sensitivity and specifity of 2D fluoroscopy reached 100% (CBCT: 100 and 83%). “Movie” showed highest sensitivity for detection of overlapping position of screws (100%). When it comes to specifity, CBCT achieved 100%. Regarding detection of only marginal overlapping position of screws, 2D fluoroscopy and “Movie” showed highest sensitivity (100%). CBCT achieved highest specifity (100%). Conclusion As for assessment of quality of fracture reduction and detection of incorrect position of plate as well as overlapping position of the three diaphyseal screws CBCT and “Movie” are comparable to CT – especially when combined. Particularly sensitivity is high compared to standard 2D fluoroscopy.

scholarly journals Complications of Volar Plating of Distal Radius Fractures: A Systematic Review

2018 ◽  
Vol 08 (03) ◽  
pp. 255-262 ◽  
Author(s):  
Todd H. Alter ◽  
Kristin Sandrowski ◽  
Gregory Gallant ◽  
Moody Kwok ◽  
Asif M. Ilyas
Keyword(s):  
Systematic Review ◽  
Distal Radius ◽  
Complication Rate ◽  
Locking Plate ◽  
Plate Fixation ◽  
Distal Radius Fractures ◽  
Complication Rates ◽  
Volar Locking Plate ◽  
Radius Fractures ◽  
Total N

Background In recent years, there has been an increased utilization of volar locking plate fixation of distal radius fractures (DRFs). However, reported long-term complication rates with this technique remain unclear. Purpose The purpose of this systematic review was to investigate the pooled incidence of complications associated with volar locking plating of DRF. Methods A search of the Scopus database was performed from 2006 through 2016. Studies were considered eligible if they had a diagnosis of a DRF and were treated with a volar locking plate with an average of 12 months or longer follow-up. Results The literature search yielded 633 citations, with 55 eligible for inclusion in the review (total n = 3,911). An overall complication rate of 15% was identified, with 5% representing major complications requiring reoperation. The most common complication types identified included nerve dysfunction (5.7%), tendon injury (3.5%), and hardware-related issues (1.6%). Conclusion Nerve complications were reportedly higher than tendon and hardware-related complications combined. However, despite varying complication rates in the literature, this systematic review reveals an overall low complication rate associated with volar locking plating of DRF.

scholarly journals Volar Locking Plate Fixations for Displaced Distal Radius Fractures: An Evaluation of Complications and Radiographic Outcomes

Hand ◽  
2017 ◽  
Vol 13 (4) ◽  
pp. 466-472 ◽  
Author(s):  
James Wilson ◽  
Jeremy J. Viner ◽  
Kavan S. Johal ◽  
Michael J. Woodruff
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Distal Radius Fractures ◽  
Complication Rates ◽  
Volar Locking Plate ◽  
Radius Fractures ◽  
Time To Surgery ◽  
Radiographic Outcomes ◽  
Plate Design

Background: A volar locking plate (VLP) is the most frequently used form of implant used for open reduction and internal fixation of distal radius fractures. They are known to have a complication rate of up to 27%. We hypothesized that plate design could influence complication rates. Methods: We performed a review of patients undergoing VLP fixation for distal radius fracture. A total of 228 patients underwent fixation with the Distal Volar Radial Anatomical (DVR) plate; 388 patients underwent fixation with the VariAx plate. Independent observers performed blinded case note and radiographic review, to assess for the quality of reduction, and complications for the inserted VLP. Results: Mean time to surgery was 6.0 days; mean follow-up was 17.5 weeks. Mean age was 56.5 years. The quality of reduction was classified as anatomical (46%), good (36.3%), moderate (13.0%), or poor (3.9%). Complications were identified in 109 patients (17%). Plate prominence was seen in 133 patients (21%). The DVR plate was less prominent ( P < .001) and had better overall radiographic appearances ( P = .025). Flexor tendon complications were related to plate prominence ( P = .005). Inferior reduction was associated with increased time to surgery ( P = .020). Conclusions: This study highlights the importance of prompt surgery, effective fracture reduction, and careful plate positioning to avoid volar prominence.

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