CT Based Characterization of Volar Surface of Distal Radius: Can an Ideal Volar Plate for Fixation of Distal Radial Fractures be Designed?

2020 ◽  
Author(s):  
Arvind Kumar ◽  
Jigyasa Passey ◽  
Dushyant Chouhan ◽  
Manish Saini ◽  
Amit Narang
Keyword(s):  
Distal Radius ◽  
Volar Plate ◽  
Distal Radial Fractures ◽  
Volar Surface

Comparative Analysis of the Complication Profile following Palmar Plating versus External Fixation of Fractures of the Distal Radius

2011 ◽  
Vol 1 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Daniel A Wartinbee ◽  
Michael Miller ◽  
Jonathan Riboh
Keyword(s):  
Grip Strength ◽  
External Fixation ◽  
Distal Radius ◽  
Plate Fixation ◽  
Volar Plate ◽  
Complication Rates ◽  
Distal Radial Fractures ◽  
Fixation Group ◽  
Vas Scores ◽  
Volar Plate Fixation

ABSTRACT Background Much attention has been given recently to the complication profile of volar plate fixation of distal radial fractures. The purpose of this investigation was to compare complication rates among patients with distal radial fractures treated with volar plating versus those treated with external fixation. Methods Two parallel series of patients with comminuted intra-articular distal radius fractures were reviewed. 59 patients were treated with external fixation and 56 patients with volar plate fixation. Postoperative radiographs, range of motion, grip strength, DASH scores, and VAS pain questionnaires were analyzed, and complications were described. Results The external fixation group had a significantly higher overall complication rate (p = 0.021) than the volar plate fixation group. In the volar plate group, there were more tendon complications and median nerve pathology. Radial shortening was greater in the external fixation group when compared to the volar plate fixation group. DASH scores and VAS scores were significantly higher in the external fixation group. Clinically, the patients in the volar plate fixation group had significantly greater arcs of motion in pronation-supination (p < 0.0001) and flexion-extension (p = 0.002) with a trend towards better grip strength (p = 0.0062). Conclusions Volar plate fixation for fractures of the distal radius provides an overall decreased incidence of complications, significantly less radial shortening, and significantly greater postoperative wrist motion when compared to external fixation. Volar plate fixation is also associated with lower VAS scores when compared to external fixation as well as DASH scores that approach statistical significance. Level of evidence III (retrospective comparative study).

Use of the "y" volar plate in the osteosynthesis of fractures of the distal radius

2019 ◽  
Vol 70 (4) ◽  
Author(s):  
Salvatore Bonfiglio ◽  
Giancarlo Salvo ◽  
Gianfranco Longo ◽  
Rocco Ortuso ◽  
Antonio Kory
Keyword(s):  
Distal Radius ◽  
Volar Plate

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 A New Volar Plate DiPhos-RM for Fixation of Distal Radius Fracture

2013 ◽  
Vol 17 (1) ◽  
pp. 41-45 ◽  
Author(s):  
Luigi Tarallo ◽  
Raffaele Mugnai ◽  
Roberto Adani ◽  
Fabio Catani
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Volar Plate ◽  
Radius Fracture

scholarly journals Fixation Strength in Full and Limited Fixation of Osteoporotic Distal Radius Fractures

Hand ◽  
2017 ◽  
Vol 13 (4) ◽  
pp. 461-465 ◽  
Author(s):  
P. Kaveh Mansuripur ◽  
Joseph A. Gil ◽  
Dale Cassidy ◽  
Patrick Kane ◽  
Augusta Kluk ◽  
...  
Keyword(s):  
Distal Radius ◽  
Peak Load ◽  
Distal Radius Fractures ◽  
Volar Plate ◽  
Fixation Strength ◽  
Joint Surface ◽  
Clinical Failure ◽  
Radius Fractures ◽  
Yield Load ◽  
Load Peak

Background: The purpose of this investigation is to determine whether osteoporotic intra-articular distal radius fractures surgically treated by filling all 7 distal screws of a volar plate will have a higher load to failure than those treated by filling only 4 distal screws. Methods: Ten matched pairs of fresh frozen cadaveric forearms were randomized within each pair to be treated by using either all 7 of the distal holes of a volar plate or only 4 distal screws. The distal radius fixation was performed with unicortical screws going to but not through the dorsal cortex, and the most distal screws were placed within 4 mm of the joint surface. An AO C2 type fracture was then created. All specimens were tested cyclically, with an axial load of 60 N, at 3 Hz for 1000 cycles to simulate early postoperative motion. All specimens were subsequently tested to mechanical failure. Results: There were no failures in either group during cyclic testing. There was no difference detected between groups for mean stiffness, yield load, peak load, or load to clinical failure. In both groups, the yield load, peak load, and load to clinical failure were higher than the 60- to 100-N forces encountered during postoperative rehabilitation. Conclusions: There was no difference detected between osteoporotic intra-articular distal radius fractures treated by utilizing all 7 of the distal screws of a volar plate compared with those treated with only 4 distal screws.

FIXATION OF AN ULNODORSAL FRAGMENT WHEN TREATING AN INTRA-ARTICULAR FRACTURE IN THE DISTAL RADIUS

Hand Surgery ◽  
2014 ◽  
Vol 19 (01) ◽  
pp. 139-144 ◽  
Author(s):  
Kazuo Ikeda ◽  
Naoki Osamura ◽  
Kaoru Tada
Keyword(s):  
Distal Radius ◽  
Surgical Procedure ◽  
Plate Fixation ◽  
Volar Plate ◽  
Dorsal Approach ◽  
Articular Fracture ◽  
Low Profile ◽  
Volar Plate Fixation ◽  
Mini Plate

If fixation of an ulnodorsal fragment in an intra-articular fracture of the distal radius is not stable, it is sometimes caused by dorsal displacement after surgery. Hence, we recommend the volar plate fixation with an additional dorsal approach and fixation of irreducible ulnodorsal fragments using a low-profile dorsal mini plate. The details of the surgical procedure and indications are discussed in this article.

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 Technique for Intramedullary Stabilization of Ulnar Neck Fractures

Hand ◽  
2017 ◽  
Vol 13 (5) ◽  
pp. 563-571
Author(s):  
Jack Abboudi ◽  
Scott M. Sandilands ◽  
C. Edward Hoffler ◽  
William Kirkpatrick ◽  
William Emper
Keyword(s):  
Distal Radius ◽  
Kirschner Wire ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Distal Radial Fractures ◽  
Percutaneous Approach ◽  
Intramedullary Stabilization ◽  
Ulna Fractures ◽  
Neck Fracture ◽  
Reproducible Method

Background: Distal ulna fractures at the ulnar neck can be seen in association with distal radius fractures, and multiple techniques have been described to address the ulnar neck component of these injuries. We have found that treatment of ulnar neck fractures can be challenging in terms of anatomy and fracture fixation. We present a new percutaneous fixation technique for ulnar neck fractures commonly seen with distal radius fractures. Technique: Fixation of the ulnar neck fracture is performed after fixation of the distal radius fracture. Our technique uses anterograde intramedullary fixation to stabilize the fracture with a 1.6-mm (0.062 inch) Kirschner wire or a commercially available metacarpal fixation intramedullary nail. The fixation is introduced into the intramedullary space of the ulnar shaft 4 to 6 cm proximal to the fracture at a separate surgical site along the subcutaneous border of the ulna. The fixation is also supported with a sugar-tong splint for the first few weeks after surgery and requires removal of the ulnar implant approximately 10 weeks after implantation. Conclusion: Our technique utilizes a percutaneous approach with minimal fracture exposure. It provides a relatively simple and reproducible method to address ulnar neck fractures commonly seen in association with distal radial fractures.

scholarly journals Volar Fixation of Dorsally Displaced Distal Radial Fracture Using Locking Compression Plate

2005 ◽  
Vol 13 (2) ◽  
pp. 153-157 ◽  
Author(s):  
KK Wong ◽  
KW Chan ◽  
TK Kwok ◽  
KH Mak
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Locking Compression Plate ◽  
Distal Radial Fracture ◽  
Radial Fracture ◽  
Distal Radial Fractures ◽  
Compression Plate ◽  
One Year ◽  
Compression Plating ◽  
Unstable Fractures

Purpose. To evaluate the functional and radiological results of treating unstable fractures of the dorsal distal radius with a volar locking plate. Methods. Dorsally displaced distal radial fractures in 30 patients (11 men and 19 women; mean age, 58.6 years) were fixed by volar locking compression plate and followed up for a minimum of one year. Results. At final functional assessment, 24 patients achieved excellent and 5 achieved good outcomes, with one patient exhibiting fair results. Radiological scores demonstrated 22 excellent and 8 good outcomes. No nonunion or infection occurred. Conclusion. Volar locking compression plating is a safe and effective treatment for unstable fractures of the dorsal distal radius.

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