Re: Screw entrapment after palmar plate fixation of a distal                 radius

The stability of palmar plate fixation using a locking compression T-plate was compared with that of a conventional palmar T-plate and a dorsal T-plate in a cadaveric model of an AO type C2 fracture of distal radius. The wrist axial load transmission through the radius was tested for each fixation. The results show that, under 100N axial load, the palmar locking compression T-plate restores stability comparable to that of the intact radius, and is superior to conventional palmar or dorsal T-plates.

Download Full-text

Locking Versus Nonlocking Palmar Plate Fixation of Distal Radius Fractures

Orthopedics ◽

10.3928/01477447-20121023-18 ◽

2012 ◽

Vol 35 (11) ◽

pp. e1613-e1617 ◽

Cited By ~ 3

Author(s):

Michael Osti ◽

Christoph Mittler ◽

Richard Zinnecker ◽

Christoph Westreicher ◽

Clemens Allhoff ◽

...

Keyword(s):

Distal Radius ◽

Plate Fixation ◽

Distal Radius Fractures ◽

Radius Fractures ◽

Palmar Plate ◽

Palmar Plate Fixation

Download Full-text

A Randomised Clinical Study Comparing Palmar and Dorsal Fixed-Angle Plates for the Internal Fixation of AO C-Type Fractures of the Distal Radius in the Elderly

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193408094706 ◽

2008 ◽

Vol 33 (5) ◽

pp. 600-604 ◽

Cited By ~ 28

Author(s):

R. G. JAKUBIETZ ◽

J. G. GRUENERT ◽

D. F. KLOSS ◽

S. SCHINDELE ◽

M. G. JAKUBIETZ

Keyword(s):

Functional Recovery ◽

Plate Fixation ◽

The Elderly ◽

Distal Radial Fractures ◽

Randomised Study ◽

Plate Group ◽

Decisive Importance ◽

Palmar Plate ◽

Surgical Treatments ◽

Palmar Plate Fixation

Current surgical treatments for distal radial fractures include dorsal and palmar plate fixation. We report results of a randomised study comparing these methods for AO C1–3 fractures. The emphasis was placed on the early postoperative functional recovery within the first 6 months as this interval is of decisive importance for elderly patients. Thirty patients with unilateral AO C1–3 fractures were enroled, 15 were treated with a palmar plate and 15 received a dorsal Pi-plate. Results were assessed 6 weeks, 3 months and 6 months postoperatively focusing on functional recovery. The palmar plate group demonstrated significantly better results in range of motion, grip strength and pain.

Download Full-text

Flexor Pollicis Longus Tendon Ruptures after Palmar Plate Fixation of Fractures of the Distal Radius

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193408100964 ◽

2009 ◽

Vol 34 (4) ◽

pp. 471-474 ◽

Cited By ~ 60

Author(s):

J. A. CASALETTO ◽

D. MACHIN ◽

R. LEUNG ◽

D. J. BROWN

Keyword(s):

Standard Treatment ◽

Plate Fixation ◽

Flexor Pollicis Longus ◽

Distal Radial Fractures ◽

Extensor Pollicis Longus ◽

Longus Tendon ◽

Palmar Plate ◽

Tendon Ruptures ◽

Flexor Pollicis Longus Tendon ◽

Palmar Plate Fixation

Palmar plate fixation of distal radial fractures is becoming a standard treatment for this common injury. Ruptures of the extensor pollicis longus tendon have been reported in 8.6% of cases after this procedure. Although palmar plate fixation has also been associated with flexor pollicis longus (FPL) tendon problems, the majority of reported cases pre-date the use of newer anatomically precontoured locking plates. In this paper seven cases of FPL rupture are presented. This complication does not appear to be unique to one type of implant. The possible aetiologies for FPL ruptures are discussed and ways to reduce the incidence of this complication are suggested.

Download Full-text

Palmar Fixation of Dorsally Displaced Distal Radius Fractures Using Locking Plates with Smartlock Locking Screws

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193408090129 ◽

2009 ◽

Vol 34 (2) ◽

pp. 173-178 ◽

Cited By ~ 9

Author(s):

T. C. WONG ◽

C. C. YEUNG ◽

Y. CHIU ◽

S. H. YEUNG ◽

F. K. IP

Keyword(s):

Distal Radius ◽

Plate Fixation ◽

Pain Syndrome ◽

Distal Radius Fractures ◽

Consecutive Series ◽

Locking Plates ◽

Radius Fractures ◽

Fracture Union ◽

Locking Screws ◽

Palmar Plate

We performed a prospective cohort study on a consecutive series of 35 unstable, dorsally displaced distal radius fractures, which were treated with palmar locking plates and SmartLock locking screws. There were 17 men and 18 women with a mean age of 44 years who were reviewed at a mean follow-up of 10 months. All the fractures healed at a mean time of 7 weeks. Radiographs did not show any change in alignment from the initial postoperative period until fracture union. The average Mayo wrist score was 90 after fracture union. One patient had an early loss of fracture reduction and one patient developed complex regional pain syndrome. There was no difference in the quality of life before and after surgery. Palmar plate fixation using SmartLock locking screws is effective and safe in stabilising unstable dorsally displaced distal radius fracture and produces good radiological and functional outcomes.

Download Full-text

LOCKING PALMAR PLATE FIXATION FOR DORSALLY DISPLACED FRACTURES OF THE DISTAL RADIUS: A PRELIMINARY REPORT

Hand Surgery ◽

10.1142/s0218810411005527 ◽

2011 ◽

Vol 16 (03) ◽

pp. 263-269 ◽

Cited By ~ 3

Author(s):

Koji Moriya ◽

Hidehiko Saito ◽

Yuji Takahashi ◽

Hiroyuki Ohi

Keyword(s):

Distal Radius ◽

Locking Plate ◽

Plate Fixation ◽

Functional Results ◽

Wrist Pain ◽

Point System ◽

Articular Fractures ◽

Palmar Plate ◽

Ulnar Wrist Pain

We reviewed a series of 62 consecutive patients with dorsally displaced fractures of the distal radius, including 20 extra-articular and 42 intra-articular fractures. All patients were treated with palmar locking plate systems at our institution between 2002 and 2006. After a minimum follow-up time of 12 weeks, the fractures had healed with satisfactory radiographic and functional results. According to the demerit point system of Gartland and Werley, 35 patients were rated excellent, 26 good, and one fair. In the good and fair groups, the demerit points were almost all for ulnar wrist pain. Our results suggest that palmar locking plate systems enable early functional mobilization with good reproducible radiographic and clinical outcomes. Since nine out of 62 patients had residual ulnar wrist pain at the final follow-up evaluation, further investigation of the pathogenesis of ulnar wrist pain is necessary to obtain better functional outcomes.

Download Full-text

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

Annals of The Royal College of Surgeons of England ◽

10.1308/003588411x12851639107151 ◽

2011 ◽

Vol 93 (1) ◽

pp. 57-60 ◽

Cited By ~ 14

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.

Download Full-text

Plate Fixation of Distal Radius Fractures

Hand Clinics ◽

10.1016/j.hcl.2021.02.008 ◽

2021 ◽

Vol 37 (2) ◽

pp. 259-266

Author(s):

Lili E. Schindelar ◽

Asif M. Ilyas

Keyword(s):

Distal Radius ◽

Plate Fixation ◽

Distal Radius Fractures ◽

Radius Fractures

Download Full-text