What happens to the posterior comminution in extra-articular fractures of the distal radius treated with volar locking plates?

Even with the invention of locking plates, intra-articular fractures of distal radius with extreme comminution remain a challenge for orthopaedic surgeons. Osteochondral graft is a potential choice to reconstruct the articular defect. We report a patient who had a fracture of distal radius with costo-osteochondral graft for articular reconstruction which has not yet been described in the English literature. At nine-year follow-up, he was pain free and had full range of movement of the wrist. The authors suggest that costo-osteochondral graft could be an option with satisfactory result.

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Unstable Extra-articular Fractures of the Distal Radius: A Prospective, Randomised Study of Immobilisation in a Cast Versus Supplementary Percutaneous Pinning

Yearbook of Hand and Upper Limb Surgery ◽

10.1016/s1551-7977(08)70097-9 ◽

2006 ◽

Vol 2006 ◽

pp. 130-131 ◽

Cited By ~ 1

Author(s):

T.R. McAdams

Keyword(s):

Distal Radius ◽

Percutaneous Pinning ◽

Randomised Study ◽

Articular Fractures ◽

Prospective Randomised Study

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Surgical treatment of fractures of the distal radius – ORIF vs external fixation with ligamentotaxis

Perspectives in Surgery ◽

10.33699/pis.2020.99.8.343-349 ◽

2020 ◽

Vol 99 (8) ◽

Keyword(s):

External Fixation ◽

Distal Radius ◽

Locking Plates ◽

X Rays ◽

Ao Classification ◽

Radial Inclination ◽

First Choice ◽

Sagittal Tilt ◽

Radial Length ◽

The Mean

Introduction: The study compares the results of open reduction using volar locking plates with ligamentotaxis by external fixation in fractures of distal radius type 2R3C according to AO classification. Methods: A retrospective study evaluating the results of osteosynthesis in patients with distal radius fractures type 2R3C according to AO classification, operated until December 2018. The ORIF method with volar locking plates (LCP) was used in 54 patients, and closed reduction with ligamentotaxis using external fixation (EF) was used in 33 patients. The mean age of the patients was 46.7 years in the LCP group and 59.6 years in the EF group. All were evaluated for their X-ray and functional outcomes and according to the Green and O’Brien score at 6 and 12 months after surgery. Results: According to X-rays at 12 months in the LCP group, the mean sagittal tilt was 10.13°, the mean radial inclination was 23.89°, and the mean radial length was 11.84 mm. In the EF group, the mean sagittal tilt was 6.32°, the mean radial inclination was 24.78°, and the mean radial length was 9.89 mm. According to the Green and O’Brien score, we recorded a mean score of 84.44 points in the LCP group at 12 month; we achieved good and excellent results in 83.33% of the patients and no poor result was observed. In the EF group the final mean score was 77.27; good and excellent results were achieved in 45.46% of the patients and a poor result in one patient. Conclusion: Based on the results in our group of patients, the internal type osteosynthesis using LCP implants can be recommended as a first-choice technique in the treatment of 2R3C fractures according to AO classification.

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Open Treatment for Displaced Articular Fractures of the Distal Radius

Clinical Orthopaedics and Related Research ◽

10.1097/00003086-198601000-00012 ◽

1986 ◽

Vol &NA; (202) ◽

pp. 103???111 ◽

Cited By ~ 5

Author(s):

CHARLES P. MELONE

Keyword(s):

Distal Radius ◽

Articular Fractures ◽

Open Treatment

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Fragment-specific fixation for complex intra-articular fractures of the distal radius: results of a prospective single-centre trial

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193412439677 ◽

2012 ◽

Vol 37 (8) ◽

pp. 765-771 ◽

Cited By ~ 16

Author(s):

A. S. Gavaskar ◽

S. Muthukumar ◽

N. Chowdary

Keyword(s):

Distal Radius ◽

Articular Surface ◽

Distal Radius Fractures ◽

First Year ◽

Functional Evaluation ◽

Radius Fractures ◽

Articular Fractures ◽

Functional Scores ◽

Radial Length ◽

Specific Fixation

The goal was to evaluate the efficacy of 2.4 mm column-specific plating for intra-articular distal radius fractures. In total, 105 patients with AO type C distal radius fractures were operated on using the locking distal radius system, Synthes. Follow-up assessments including clinical (wrist and forearm range of motion, grip strength), radiological (articular step, radial length and inclination, volar tilt, and ulnar variance), and functional scores (Disabilities of the Arm, Shoulder, and Hand; Patient Rated Wrist Evaluation) were made at regular intervals until 1 year. Union was obtained in all patients. Articular surface was anatomically reconstructed in 74 patients (70.5%). Clinical and functional evaluation showed significant continuous improvements over the first year. C1 fractures had a better chance of anatomical reduction compared with C2 and C3 fractures. Fracture type, quality of reduction, and presence of degenerative changes did not show a significant effect on functional outcome scores. Column-specific fixation of the distal radius can achieve satisfactory results in complex intra-articular fractures.

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