Re: Dukan R, Krief E, Nizard R. Distal radius fracture volar locking plate osteosynthesis using wide-awake local anaesthesia. J Hand Surg Eur. 2020, 45: 857–63

2021 ◽  
Vol 46 (4) ◽  
pp. 438-439
Author(s):  
Luke Geoghegan ◽  
Maxim D. Horwitz ◽  
Ruben Dukan
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Local Anaesthesia ◽  
Locking Plate ◽  
Plate Osteosynthesis ◽  
Radius Fracture ◽  
Volar Locking Plate ◽  
Locking Plate Osteosynthesis ◽  
Wide Awake

Use of Computed Tomography in Determining the Occurrence of Dorsal and Intra-articular Screw Penetration in Volar Locking Plate Osteosynthesis of Distal Radius Fracture

2018 ◽  
Vol 23 (01) ◽  
pp. 26-32 ◽  
Author(s):  
Teik Wei Diong ◽  
Nor Hazla Mohamed Haflah ◽  
Abdul Yazid Mohd Kassim ◽  
Sharifah Majedah Idrus Al Habshi ◽  
Mohd Hassan Shukur
Keyword(s):  
Ct Scan ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Locking Plate ◽  
Plate Osteosynthesis ◽  
Plain Radiograph ◽  
Radius Fracture ◽  
Volar Locking Plate ◽  
Screw Length ◽  
Screw Penetration

Background: The use of volar locking plate in distal radius fracture can lead to extensor tendon rupture due to dorsal screw penetration. The aim of our study was to investigate the occurrence of dorsal and intra-articular screw penetration using CT scan after volar distal radius osteosynthesis for distal radius fractures.Methods: Thirty patients who underwent distal volar locking plate for distal radius fracture were included in a retrospective study. In all 30 patients no dorsal and intra-articular screw penetration were detected on standard AP and lateral views of a plain radiograph. CT scan of the operated wrist was performed to determine the number of intra-articular and dorsal screw penetrations. Clinical examination was performed to determine the wrist functions in comparison to the normal wrist.Results: Nineteen wrists were noted to have screw penetration either dorsally or intraarticularly. The highest incidence is in the 2nd extensor compartment where 13 screws had penetrated with a mean of 2.46 mm. Six screws penetrated into the distal radial ulnar joint and five screws into the wrist joint with a mean of 2.83 mm and 2.6 mm, respectively. However, there was no incidence of tendon irritation or rupture.Conclusions: This study demonstrated a high incidence of dorsal and intra-articular screw penetration detected by CT scan which was not apparent in plain radiograph. We recommend that surgeons adhere to the principle of only near cortex fixation and downsizing the locking screw length by 2 mm.

Surgical Technique of Corrective Osteotomy for Malunited Distal Radius Fracture Using the Computer-Simulated Patient Matched Instrument

2016 ◽  
Vol 21 (02) ◽  
pp. 133-139 ◽  
Author(s):  
Tsuyoshi Murase
Keyword(s):  
Bone Graft ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Locking Plate ◽  
Corrective Osteotomy ◽  
Extensor Tendon ◽  
Radius Fracture ◽  
Soft Tissue Release ◽  
Dorsal Plate ◽  
Volar Locking Plate

The conventional corrective osteotomy for malunited distal radius fracture that employs dorsal approach and insertion of a trapezoidal bone graft does not always lead to precise correction or result in a satisfactory surgical outcome. Corrective osteotomy using a volar locking plate has recently become an alternative technique. In addition, the use of patient-matched instrument (PMI) via computed tomography simulation has been developed and is expected to simplify surgical procedures and improve surgical precision. The use of PMI makes it possible to accurately position screw holes prior to the osteotomy and simultaneously perform the correction and place the volar locking plate once the osteotomy is completed. The bone graft does not necessarily require a precise block form, and the problem of the extensor tendon contacting the dorsal plate is avoided. Although PMI placement and soft tissue release technique require some degree of specialized skill, they comprise a very useful surgical procedure. On the other hand, because patients with osteoporosis are at risk of peri-implant fracture, tandem ulnar shortening surgery should be considered to avoid excessive lengthening of the radius.

scholarly journals Minimally Invasive Plate Osteosynthesis for a Distal Radius Fracture with Forearm Skin Problem

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Kiyohito Naito ◽  
Yoichi Sugiyama ◽  
Mayuko Kinoshita ◽  
Ahmed Zemirline ◽  
Chihab Taleb ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Distal Radius ◽  
Skin Disorder ◽  
Locking Plate ◽  
Plate Osteosynthesis ◽  
Volar Locking Plate ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Locking Plate Osteosynthesis ◽  
The Right

In this study, we performed osteosynthesis for a distal radius fracture using a minimally invasive approach for a patient with skin disorder of the forearm and obtained favorable results. This case report may provide new findings confirming the usefulness of this surgical approach for distal radius fractures. Blister formation on the right forearm was observed in a 53-year-old female who was diagnosed with a distal fracture of the right radius and underwent splinting in a local hospital, and she was referred to our hospital 2 days after the injury. Minimally invasive locking plate osteosynthesis was performed, and there was no skin lesion at this incision site. Postoperatively, there were no complications in soft tissues and the operative scar was almost unrecognizable. We reported volar locking plate osteosynthesis using the minimally invasive approach in a patient with skin disorder of the forearm. Such patients are rarely encountered. However, this minimally invasive approach is extremely useful for utilizing the advantages of volar locking plate fixation without being affected by the soft tissue environment.

scholarly journals Clinical and Functional Outcome of Volar Locking Plate Fixation for Distal Radius Fracture

2009 ◽  
Vol 58 (2) ◽  
pp. 283-286 ◽  
Author(s):  
Shoichi Kuba ◽  
Itaru Furuichi ◽  
Masakazu Murata ◽  
Takeshi Miyaji ◽  
Noriaki Miyata ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Locking Plate ◽  
Plate Fixation ◽  
Radius Fracture ◽  
Volar Locking Plate ◽  
Locking Plate Fixation

The Role of Early Post-Operative Radiographs Following Distal Radius Fracture Fixation with a Volar Locking Plate: Time for Change?

2019 ◽  
Vol 24 (04) ◽  
pp. 435-439
Author(s):  
Vivek Sharma ◽  
Caroline Witney-Lagen ◽  
Samuel Cullen ◽  
Edward Kim ◽  
Zakir Haider ◽  
...  
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Locking Plate ◽  
Clinical Information ◽  
Median Number ◽  
Radius Fracture ◽  
Volar Locking Plate ◽  
Articular Fractures ◽  
Fracture Management

Background: The role of early radiographic imaging in the management of distal radius fractures (DRFs) is unclear. The aim of this study was to assess whether early post-operative radiographs for DRFs influences the ongoing management of this patient group. We hypothesize that routine early radiographs do not influence the management of DRFs. Methods: This was a retrospective review of patients undergoing open reduction and internal fixation using a volar locking plate between 2012 and 2017 at our institution. Patients were identified using hospital electronic databases. Clinical information was gathered from the electronic health records and PACS systems and analysed on a spreadsheet. An early post-operative radiograph was defined by the authors as imaging on a patient’s first postoperative visit. Results: 237 patients were identified. The median number of days patients were reviewed post-operatively was 13 (interquartile range 9–16). 172 (73.1%) patients had early post-operative radiographs, with 100 (58.1%) intra-articular and 72 (41.9%) extra-articular fractures. Of patients who underwent imaging, 7 (4.0%) had their post-operative fracture management altered (7 intra-articular, 0 extra-articular) with 1 (0.58%) requiring immediate surgical revision as indicated by imaging. Conclusions: Our study questions the value of routine early post-operative radiographs in the management of distal radius fracture fixations, in particular if the fracture is extra-articular. This is of importance in the setting of constrained resources and represents a poor use of limited healthcare facilities, as well as unnecessary radiation exposure.

scholarly journals Pain Management during Rehabilitation after Distal Radius Fracture Stabilized with Volar Locking Plate: A Prospective Cohort Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Pengbo Luo ◽  
Jinjie Lou ◽  
Shengwu Yang
Keyword(s):  
Pain Management ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Locking Plate ◽  
Rehabilitation Program ◽  
Radius Fracture ◽  
Dash Score ◽  
Volar Locking Plate ◽  
Vas Scores ◽  
Pain At Rest

Introduction. Internal fixation with volar locking plate (VLP) was widely adopted as a first-line choice in treatment of distal radius fracture (DRF). Methods. Total 315 patients with distal radius fracture receiving VLP fixation were included for analysis in this study. The rehabilitation protocol was started immediately after surgery for all patients. During the initial two weeks after surgery, 149 patients received 200 mg celecoxib twice per day, 89 received buprenorphine transdermal patch at 5 μg/h, and 77 received 13 mg codeine plus 200 mg ibuprofen twice per day for pain management. Visual analog scale (VAS) scores of pain at rest, daily activity, and rehabilitative exercise were measured, respectively, every week according to the experiences of the past week in the initial six weeks after surgery. Functional outcomes including range of motion (ROM) for extension, flexion, pronation, supination, ulnar and radial abduction, the disabilities of arm, shoulder, and hand (DASH) score and the validated patient rated wrist evaluation (PRWE), and grip strength were collected at one, three, and six months after surgery. Results. We showed that patients receiving transdermal buprenorphine and codeine/ibuprofen had decreased VAS scores during rehabilitative exercise, better compliance to the rehabilitation program, and thus faster functional recovery. Conclusions. We recommend transdermal buprenorphine or codeine/ibuprofen for pain management during rehabilitation after distal radius fracture stabilized with VLP.

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