Ultrasonic Evaluation of the Flexor Pollicis Longus Tendon Following Volar Plate Fixation for Distal Radius Fractures

2016 ◽  
Vol 41 (3) ◽  
pp. 374-380 ◽  
Author(s):  
Adnan Kara ◽  
Haluk Celik ◽  
Mujdat Bankaoglu ◽  
Yunus Oc ◽  
Murat Bulbul ◽  
...  
Keyword(s):  
Distal Radius ◽  
Plate Fixation ◽  
Distal Radius Fractures ◽  
Volar Plate ◽  
Flexor Pollicis Longus ◽  
Radius Fractures ◽  
Longus Tendon ◽  
Ultrasonic Evaluation ◽  
Volar Plate Fixation ◽  
Flexor Pollicis Longus Tendon

scholarly journals Correlation of Flexor Pollicis Longus Tendon Status by Ultrasonography with Plate Position on Radiographs Following Volar Plate Fixation of Distal Radius Fractures with Pronator Quadratus Repair

2021 ◽  
Author(s):  
Anil. K. Bhat ◽  
Ashwath. M. Acharya ◽  
Prajwal P. Mane ◽  
Lakshmikanth. H. Karegowda
Keyword(s):  
Distal Radius ◽  
Plate Fixation ◽  
Distal Radius Fractures ◽  
Flexor Pollicis Longus ◽  
Radius Fractures ◽  
Pronator Quadratus ◽  
Longus Tendon ◽  
Flexor Pollicis Longus Tendon ◽  
Grade One

Abstract Background Purpose was to correlate flexor pollicis longus tendon (FPL) attrition using Ultrasonography with plate position on radiographs following volar locked compression plate fixation (LCP) in patients who have undergone pronator quadratus (PQ) repair for distal radius fractures. Methods Status of flexor pollicis longus tendon was analyzed by ultrasonography in patients who underwent volar locked compression plating with pronator quadratus repair at a minimum of one year follow up. Soong’s criteria was used to assess the plate position and then correlated the ultrasonography findings of flexor pollicis longus. Results There were 33 patients included in our study, of which 15 belonged to Soong’s grade zero, 10 were grade one and eight were grade two. Flexor pollicis longus attrition was noted in all cases with grade two plating. Conclusion Pronator quadratus repair may not prevent attritional changes in higher grades of Soong’s, hence follow up may be required in these patients to identify attritional changes and early implant removal to prevent complications.

Flexor Pollicis Longus Dysfunction After Volar Plate Fixation of Distal Radius Fractures

2013 ◽  
Vol 38 (9) ◽  
pp. 1691-1697 ◽  
Author(s):  
Brian J. Chilelli ◽  
Ronak M. Patel ◽  
David M. Kalainov ◽  
Jie Peng ◽  
Li-Qun Zhang
Keyword(s):  
Distal Radius ◽  
Plate Fixation ◽  
Distal Radius Fractures ◽  
Volar Plate ◽  
Flexor Pollicis Longus ◽  
Radius Fractures ◽  
Volar Plate Fixation

scholarly journals Assessment of Pronator Quadratus Repair Integrity Using Dynamic Ultrasonography Following Volar Plate Fixation for Distal Radius Fractures

Hand ◽  
2018 ◽  
Vol 15 (1) ◽  
pp. 111-115 ◽  
Author(s):  
Richard M. Hinds ◽  
Nicole Montero-Lopez ◽  
Kenneth Brock ◽  
Ronald Adler ◽  
Anthony Sapienza ◽  
...  
Keyword(s):  
Distal Radius ◽  
Plate Fixation ◽  
Distal Radius Fractures ◽  
Volar Plate ◽  
Wrist Flexion ◽  
Radius Fractures ◽  
Pronator Quadratus ◽  
Outcome Scores ◽  
Volar Plate Fixation ◽  
Flexor Pollicis Longus Tendon

Background: Previous work evaluating the pronator quadratus (PQ) muscle following volar plate fixation (VPF) of distal radius fractures (DRF) suggests that PQ repair often fails in the postoperative period. The purpose of this investigation was to assess PQ repair integrity following VPF of DRF using dynamic musculoskeletal ultrasonography. Methods: Twenty adult patients who underwent VPF of DRF with repair of the PQ with a minimum follow-up of 3 months underwent bilateral dynamic wrist ultrasonography. The integrity of the PQ repair, wrist range of motion (ROM) and strength, and functional outcome scores were assessed. Results: Mean patient age at the time of surgery was 59 ± 14 years, and 50% underwent VPF of their dominant wrist. Patients were evaluated at a mean 9 ± 4 months after VPF. All patients had an intact PQ repair. The volar plate was completely covered by the PQ in 55% of patients and was associated with a larger PQ when compared to patients with an incompletely covered volar plate ( P = .026). The flexor pollicis longus tendon was in contact with the volar plate in 20% of patients, with those patients demonstrating a trend toward significantly increased wrist flexion ( P = .053). No difference in ROM, strength, or outcome scores was noted among wrists with completely or incompletely covered volar plates. Conclusions: The PQ demonstrates substantial durability after repair following VPF. Wrist ROM, strength, and functional outcomes are similar in wrists in which the volar plate is completely or incompletely covered by the repaired PQ.

scholarly journals Minimising the risk of extensor pollicis longus rupture following volar plate fixation of distal radius fractures: a cadaveric study

2011 ◽  
Vol 93 (1) ◽  
pp. 57-60 ◽  
Author(s):  
DC Perry ◽  
DMG Machin ◽  
JA Casaletto ◽  
DJ Brown
Keyword(s):  
High Risk ◽  
Distal Radius ◽  
Plate Fixation ◽  
Tendon Injury ◽  
Distal Radius Fractures ◽  
Volar Plate ◽  
Radius Fractures ◽  
Extensor Pollicis Longus ◽  
Fixed Angle ◽  
Volar Plate Fixation

INTRODUCTION Rupture of extensor pollicis longus (EPL) tendon is a recognised complication following volar plate fixation of distal radius fractures, usually from attrition caused by prominent screws. We sought to identify the screw holes in some of the most commonly used plates which may precipitate tendon injury. SUBJECTS AND METHODS Three fixed-angle volar locking plates were sequentially positioned into 18 cadaveric arms. A wire was passed through each of the holes in the plates using a locking guide and the dorsal relationships noted. RESULTS Each plate had specific ‘high-risk’ holes which directed the wire towards the EPL groove. The central screw holes appeared mostly implicated in EPL injury. CONCLUSIONS Awareness of ‘high-risk’ holes and appropriate minor alterations in surgical technique may consequently decrease the incidence of EPL irritation and rupture.

scholarly journals Volar Plate Fixation with AO Distal Radius Plate (DRP) for Distal Radius Fractures

2005 ◽  
Vol 54 (3) ◽  
pp. 611-616
Author(s):  
Kazunobu Arakaki ◽  
Hikaru Tashima ◽  
Yosuke Asahara ◽  
Chikara Deguchi ◽  
Futoshi Kuga
Keyword(s):  
Distal Radius ◽  
Plate Fixation ◽  
Distal Radius Fractures ◽  
Volar Plate ◽  
Radius Fractures ◽  
Volar Plate Fixation

scholarly journals Evaluation of Flexor Pollicis Longus Tendon Rupture after Treatment of Distal Radius Fracture with the Volar Plate

2020 ◽  
Vol 09 (03) ◽  
pp. 219-224 ◽  
Author(s):  
Kamil Yamak ◽  
Hüseyin Gökhan Karahan ◽  
Berrak Karatan ◽  
Cemil Kayalı ◽  
Taşkın Altay
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Tendon Rupture ◽  
Flexor Tendon ◽  
Plate Fixation ◽  
Volar Plate ◽  
Flexor Pollicis Longus ◽  
Radius Fractures ◽  
Volar Plate Fixation

Abstract Background The aim of this study is to evaluate the frequency of flexor pollicis longus (FPL) tendon rupture and factors leading to this rupture during the follow-up of patients who underwent volar plate fixation because of distal radius fracture. Patients and Methods A total of 109 distal radius fractures of 102 patients treated with volar plate fixation and periodically followed up for at least 1 year between January 2013 and May 2018 were evaluated. Fractures were categorized according to the AO Foundation/Orthopaedic Trauma Association (AO/OTA) Fracture-Dislocation Classification and Soong's grading was used for classifying volar plate position. All patients operated were inquired retrospectively in terms of flexor tendon rupture. Results Gender distribution revealed 45 females and 57 males. Mean age was 47.9 (range: 17–88) years. Mean period of follow-up was 27 months. Distribution of fractures in accordance with the AO/OTA distal radius classification was 6, 8, 7, 12, 24, 33, 11, and 8 patients with types A2, A3, B1, B2, B3, C1, C2, and C3, respectively. When volar plate positions were analyzed with Soong's classification, it revealed that 79 (72.4%), 23 (21.1%), and 7 (6.5%) plates were grade 0, 1, and 2, respectively. In total, evaluating the three patients with FPL rupture, it revealed that the volar plate was positioned distally during fixation because the fracture line had advanced to the distal of the watershed line, the distal portion of the plate had lost complete connection with the bone, and at this portion, it was observed that the pronator quadratus muscle was not covering the plate entirely (Soong's classification grade 2). Patients did not have additional flexor tendon injury. Conclusion FPL tendon rupture is a rare but serious complication of volar plate fixation performed for distal radius fractures. We believe that appropriate choice of implant and careful surgical technique, along with the close follow-up of patients, with Soong's classification grade-2 volar positions would help in preventing this complication. Level of Evidence This is a Level 3a, differential diagnosis/symptom prevalence study.

scholarly journals Immobilization following Distal Radius Fractures: A Randomized Clinical Trial

2018 ◽  
Vol 07 (05) ◽  
pp. 409-414
Author(s):  
J. Hill ◽  
Gabriel Bouz ◽  
Ali Azad ◽  
William Pannell ◽  
R. Alluri ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Outcome Measures ◽  
Distal Radius ◽  
Plate Fixation ◽  
Distal Radius Fractures ◽  
Volar Plate ◽  
Dash Score ◽  
Radius Fractures ◽  
Volar Plate Fixation

Background No consensus exists regarding postoperative splinting position following volar plate fixation of distal radius fractures. Purpose The purpose of this study was to determine whether immobilization in supination would result in superior outcomes compared with no restriction of forearm range of motion. Patients and Methods All patients >18 years of age with distal radius fractures indicated for volar plate fixation were eligible. Exclusion criteria were open fracture and concomitant injury to, or functional deficit of, either upper extremity. Patients were randomized to immobilization in (1) maximal supination with a sugar-tong splint or (2) no restriction of supination with a volar splint. Patient-Rated Wrist Evaluation (PRWE), Disabilities of the Arm, Shoulder, and Hand (DASH) score, and visual analog scale (VAS) score; wrist range of motion; and grip strength were recorded at 2 and 6 weeks postoperatively. A Student's t-test was used to compare mean values of all outcome measures at each time point. Results A total of 46 patients enrolled in the study; 28 were immobilized with a volar splint and 18 were immobilized with a sugar-tong splint. Six-week follow-up data were obtained for 32 patients. There was no significant difference in PRWE, DASH, and VAS scores; or range of motion; or grip strength between the two groups postoperatively. Conclusion Range of motion, grip strength, and patient-rated outcome measures were similar regardless of postoperative immobilization technique in patients with a distal radius fractures stabilized with a volar plate. Surgeons can elect to use the standard-of-care postoperative immobilization modality of their preference following volar plate fixation without compromising short-term return to function. Level of Evidence This is a Level II, therapeutic study.

Sign in / Sign up

Export Citation Format

Share Document