A Biomechanical Comparison of Volar Locked Plating of Intra-Articular Distal Radius Fractures: Use of 4 Versus 7 Screws for Distal Fixation

Background: Owing to the many unique disease characteristics of Parkinson disease (PD)—namely resting tremors, muscular rigidity, and poor bone quality—we hypothesized that this patient population would have inferior outcomes with surgical management of acute distal radius fractures (DRFs) compared with the literature available on the general population. Methods: This is a retrospective observational study performed at a single, level 1, academic center from 2001 to 2020 capturing all adult patients with an isolated, acute, and closed DRF that ultimately underwent operative treatment. International Classification of Diseases 10 codes were used to identify 30 patients for manual chart review. Several patient and fracture characteristics were accounted for and complications, reoperations, and failures of surgical intervention were recorded. Results: There was a total of 7/30 failures (23%), 6/30 reoperations (20%), and 12 complications in 9/30 wrists (complication rate, 30%) at a mean latest follow-up of 11 months (1.2-158 months). Of the 7 failures, 5 were due to loss of reduction, and 2 of them were deep infections with mean time to failure of 8.3 weeks (range, 11 days-5.2 months). Conclusions: This study found a high rate of complications, reoperations, and early failure despite a short follow-up period and a small cohort of patients with PD treated surgically for a DRF. We recommend locked plating if suitable for the fracture type and early involvement of a multidisciplinary team to assist with medical optimization of PD to increase chances of a successful outcome.

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Quality of life after volar locked plating: a 10-year follow-up study of patients with intra-articular distal radius fractures

BMC Musculoskeletal Disorders ◽

10.1186/1471-2474-15-250 ◽

2014 ◽

Vol 15 (1) ◽

Cited By ~ 10

Author(s):

Paul Ruckenstuhl ◽

Gerwin A Bernhardt ◽

Patrick Sadoghi ◽

Mathias Glehr ◽

Lukas A Holzer ◽

...

Keyword(s):

Quality Of Life ◽

Distal Radius ◽

Distal Radius Fractures ◽

Radius Fractures ◽

Locked Plating ◽

Follow Up Study

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A55 Numbers and locations of screws influence fixation stability in palmar locked plating of distal radius fractures

Injury ◽

10.1016/s0020-1383(11)70072-9 ◽

2011 ◽

Vol 42 ◽

pp. S15

Author(s):

G. Stein ◽

C. Reissig ◽

G. Gradl ◽

K.J. Burkhart ◽

L.P. Müller

Keyword(s):

Distal Radius ◽

Distal Radius Fractures ◽

Radius Fractures ◽

Locked Plating ◽

Fixation Stability

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Outcomes of Supplementary Spring Wire Fixation With Volar Plating for Volar Lunate Facet Fragments in Distal Radius Fractures

Hand ◽

10.1177/1558944720976404 ◽

2020 ◽

pp. 155894472097640

Author(s):

Nathaniel Fogel ◽

Lauren M. Shapiro ◽

Allison Roe ◽

Sahitya Denduluri ◽

Marc J. Richard ◽

...

Keyword(s):

Distal Radius ◽

Distal Radius Fractures ◽

Wrist Flexion ◽

Volar Plating ◽

Radius Fractures ◽

Locked Plating ◽

Spring Wire ◽

Flexion Extension ◽

Wire Fixation ◽

The Mean

Background Intra-articular distal radius fractures with small volar lunate facet fragments can be challenging to address with volar plate fixation alone. Volar locked plating with supplementary spring wire fixation has been previously described in a small series but has not been further described in the literature. We hypothesized that this technique can provide adequate fixation for volar lunate facet fragments smaller than 15 mm in length, which are at risk of displacement. Methods We completed a retrospective chart review (2015-2019) of patients who underwent volar locked plating with the addition of supplementary spring wire fixation for intra-articular distal radius fractures with a volar lunate facet fragment (<15 mm). Postoperative radiographs were assessed to evaluate union, evidence of hardware failure, escape of the volar lunate facet fragment, and postoperative volar tilt. Clinical outcome was assessed with wrist flexion/extension, arc of pronosupination, and Quick Disabilities of the Arm, Shoulder, and Hand Score ( QuickDASH) scores. Results Fifteen patients were identified, of which all went on to fracture union. There were no hardware failures or escape of the volar lunate facet fragment at final follow-up. One patient underwent hardware removal for symptoms of flexor tendon irritation. The mean wrist flexion was 59°, wrist extension was 70°, pronation was 81°, and supination was 76°. The mean QuickDASH score was 18.5. The mean postoperative volar tilt was 3.6°. Conclusions Supplementary spring wire fixation with standard volar plating provides stable fixation for lunate facet fragments less than 15 mm. This technique is a safe and reliable alternative to commercially available fragment-specific implants.

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