The minimally invasive approach for distal radius fractures and malunions

2017 ◽  
Vol 43 (2) ◽  
pp. 121-130 ◽  
Author(s):  
Philippe A. Liverneaux
Keyword(s):  
Distal Radius ◽  
Minimal Invasive ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Pronator Quadratus ◽  
Invasive Approach ◽  
Anterior Cortex ◽  
Flexor Carpi Radialis ◽  
Articular Fractures ◽  
Minimal Invasive Approach

This article reviews the author’s currently used minimal invasive approach for volar plating of distal radius fractures. A single longitudinal incision of 1.5 cm is drawn on the lateral aspect of the flexor carpi radialis tendon in order to insert a plate under the pronator quadratus. With the wrist flexed, the plate is applied on the anterior cortex of the radius to reduce the fracture. This approach offers the advantage of preserving ligamentotaxis, which facilitates the reduction, and the small scar improves the cosmetics. It is mainly indicated for extra-articular and simple intra-articular fractures of the distal radius. Relative contraindications are comminuted articular fractures in elderly osteoporotic patients. Functional and radiological results are comparable with those obtained with an extended flexor carpi radialis approach. My colleagues and I have used it for more than 2000 cases since 2012. This technique requires practise. Attempted conversion to a larger incision is possible in case of difficulty, but this is seldom necessary.

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

2012 ◽  
Vol 37 (8) ◽  
pp. 765-771 ◽  
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.

The Fate of Pronator Quadratus Muscle after Volar Locking Plating of Unstable Distal Radius Fractures

2014 ◽  
Vol 27 (3) ◽  
pp. 191
Author(s):  
Chae-Hyun Lim ◽  
Heun-Guyn Jung ◽  
Ju-Yeong Heo ◽  
Young-Jae Jang ◽  
Yong-Soo Choi
Keyword(s):  
Distal Radius ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Pronator Quadratus ◽  
Pronator Quadratus Muscle

Minimal invasive plating of distal radius fractures. A safe procedure?

2019 ◽  
Vol 224 ◽  
pp. 172-178 ◽  
Author(s):  
T. Neubauer ◽  
M. Plecko ◽  
S. Grechenig ◽  
A. Hartmann ◽  
R. Ortmaier ◽  
...  
Keyword(s):  
Distal Radius ◽  
Minimal Invasive ◽  
Distal Radius Fractures ◽  
Safe Procedure ◽  
Radius Fractures

Fixation of Distal Radius Fractures Using AO Titanium Volar Distal Radius Plate

Hand Surgery ◽  
2003 ◽  
Vol 08 (01) ◽  
pp. 7-15 ◽  
Author(s):  
H. C. Lee ◽  
Y. S. Wong ◽  
B. K. Chan ◽  
C. O. Low
Keyword(s):  
Distal Radius ◽  
Tendon Rupture ◽  
Open Reduction Internal Fixation ◽  
Distal Radius Fractures ◽  
Titanium Plate ◽  
Radius Fractures ◽  
Articular Fractures ◽  
Effective Treatment Modality ◽  
Wrist Function

This study is to assess the effectiveness and outcome of the AO titanium volar distal radius plate (Synthes) in the treatment of peri-articular volar rim fractures of the distal radius. It was conducted on 22 patients with distal radius fractures who underwent open reduction, internal fixation using the AO titanium volar distal radius plate between July 1998 and December 1999 at the Changi General Hospital. The radiographs of the patients were analysed upon fracture union and assessment of wrist function was done using Gartland and Werley criteria. There were four extra-articular AO Type A2(1) and A3(3): the remaining 18 intra-articular fractures consisted of AO B3(2), AO C1(11), AO C2(2) and AO C3(3). The average follow-up period was 12.6 months (range 7–23). Radiological review showed bone healing in 21 patients (95.5%) and good articular congruity for all intra-articular fractures with less than 2 mm step-off. Three patients defaulted follow-up. Complications were few with one wound infection, one tendon rupture and three neuropraxia of the superficial radial nerve. Wrist function was excellent in three patients, good in 12 and fair in four. The AO titanium plate with its distal buttressing ability is an effective treatment modality in patients with distal radius fractures involving the peri-articular volar rim.

scholarly journals External and internal fixation for comminuted intra-articular fractures of distal radius

1970 ◽  
Vol 7 (4) ◽  
pp. 369-373 ◽  
Author(s):  
RL Pradhan ◽  
S Lakhey ◽  
BK Pandey ◽  
RR Manandhar ◽  
KP Rijal ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
External Fixation ◽  
Distal Radius ◽  
Open Reduction ◽  
Distal Radius Fractures ◽  
High Rate ◽  
Volar Plating ◽  
Radius Fractures ◽  
Articular Fractures

Background: Distal radius fractures are a common injury and without proper treatment leads to high functional impairment and frequent complications. Objective: The aim of this study was to see the functional outcome in patients with comminuted distal radius fractures treated with combined external fixation and open reduction with volar plating. Materials and methods: All comminuted distal radius fractures classified as type C in AO/OTA classification were enrolled for the study from 2005 till 2008. The clinical scoring chart modified by Cooney was used to evaluate the functional outcome. Results: There were twenty-two patients with the average age of 42.18 years (range 19-60) with 15 male and 7 females. The follow-up period was from 14 to 46 months. Accordingly, there were 11 (50%) excellent, 7 (31%) good, 2 (9%) fair and 2 (9%) poor results. There were very few complications in our series. In three patients additional K-wire supplementation was necessary along with external and open internal fixation. Conclusions: Comminuted intra-articular fractures of distal radius should be treated by open reduction and combined internal and external fixation to achieve a high rate of patient satisfaction and satisfactory functional outcome. Key words: distal radius fractures; volar plating; external fixationDOI: 10.3126/kumj.v7i4.2756 Kathmandu University Medical Journal (2009) Vol.7, No.4 Issue 28, 369-373

scholarly journals Clinical outcomes in management of unstable distal radius fractures treated with external fixation and internal fixation: a prospective comparative study

2017 ◽  
Vol 3 (5) ◽  
pp. 1004 ◽  
Author(s):  
Sunil Kumar Dash ◽  
Manish Kumar Sharma ◽  
Sanket Mishra ◽  
Hatia Marandi ◽  
Aurobinda Das ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Functional Recovery ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
Dash Score ◽  
Radius Fractures ◽  
Articular Fractures ◽  
Group I

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Management of Distal Radius fracture that are inherently unstable is still a matter of debate. There is no conclusive evidence that support one surgical fixation method over another. An attempt was made to analyze patients treated with Ex-Fix and Internal-Fixation for unstable distal radius fractures and evaluate the clinical efficacy of Ex-fix using principles of ligamentotaxis and Internal-fixation and compare functional recovery, fracture healing time and complications</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A prospective trial was undertaken at our hospital with 35 patients,all aged &gt;20 yrs with closed distal radius fracture and divided into two groups: group I (Ex-fix with or without percutaneous k-wire, and JESS) and group II (Int-Fixation) including 14 and 21 patients, respectively. Periodic clinical examination and x-ray review was carried out to find out fracture union, and functional assessment. Patients were followed up for 1 year, 6 months average</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Group I consumed significant less operative time, fluoroscopic exposure, reduced hospital stay, quicker post-operative pain relief. Quick DASH score were significantly high in elderly treated with Ex-Fix in comparison to young in which DASH score was higher with internal-fixator. Functional recovery was early with int-fixation but post-operative wrist stiffness was also higher. 2 cases of delayed wound healing &amp;1 case of pin tract infection with ex-fix application was observed</span><span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Internal-fixation remains the treatment of choice for unstable distal radius fracture involving the articular surface and in the young, while ext-fixation can be considered as a primary treatment modality in the extra-articular fractures in young or even intra-articular fractures in the elderly</span><span lang="EN-IN">.</span></p>

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.

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