scholarly journals The Usefulness of Radial Column Plate in Distal Radius Fracture: Indications and Results

Author(s):  
Sung Jin An ◽  
Sang Hyun Lee ◽  
Dong Hee Kim ◽  
Hyo Seok Jang ◽  
Sung Min Hong ◽  
...  

Purpose: The most common surgical treatment for distal radius fracture is internal fixation using volar locking plates, but it is sometimes difficult to maintain reduction with them. Therefore, this research reports the results of surgical treatment with additional radial column plates.Methods: We analyzed 12-month follow-up results in 100 cases. The patients had the B or C types of distal radius fractures, in accordance with AO classification, and underwent surgical treatment at our hospital from May 2013 to December 2019. There were 16 cases of B-type and 84 cases of C-type fractures. Out of these, 87 were treated with volar locking plates (V group) and 13 had additional radial column plates (VR group). The results of surgical treatment were examined clinically by measuring the disabilities of the arm, shoulder and hand (DASH) and Mayo wrist score, and radiologically by measuring the radial length, radial inclination, and volar tilt, before and after surgery.Results: After treatment, the radiographic average in the V group showed a radial length of 12.3 mm, radial inclination of 20.2°, and volar tilt of 5.8°, while the VR group showed 11.6 mm, 22.3°, and 9.0° respectively. A statistically significant difference was found in the DASH score, and the DASH score showed good results in the VR group.Conclusion: Additional radial column plate fixation is worth considering because it provides clinically and radiologically satisfactory results in treatment of B and C types distal radius fracture involving articular surface.

2014 ◽  
Vol 3 (1) ◽  
Author(s):  
Edi Burhan ◽  
Menker Manjas ◽  
Ardian Riza ◽  
Erkadius Erkadius

AbstrakFraktur metafise distal radius merupakan fraktur dengan insiden tertinggi kedua pada usia tua di luar fraktur daerah panggul. Di Rumah Sakit Dr. M. Djamil Padang terdapat 122 dari 612 kasus fraktur radius, antara Januari 2011 – Juni 2012. Tujuan utama terapi ini adalah pengembalian permukaan sendi ke posisi anatomis dengan fiksasi yang stabil dan pengembalian fungsi extremitas atas semaksimal mungkin. Metode: Penelitian ini berupa penelitian retrospektif yang dilakukan di poliklinik orthopaedi RSUP Dr M Djamil Padang pada bulan November-Desember 2012 pada pasien fraktur metafise distal radius intraartikuler usia muda yang mendapat tindakan operatif dibandingkan dengan kelompok non-operatif dengan penilaian klinis Quick DASH Score. Sampel yang digunakan sebanyak 30 orang dari 55 orang yang memenuhi kriteria inklusi. Hasil: Ada hubungan yang bermakna antara fungsi extremitas atas dengan penilaian Quick DASH Score antara tindakan operatif pada fraktur distal radius intraartikuler usia muda dengan tindakan non-operatif (p Fisher = 0,010). Tidak terdapat hubungan bermakna antara Quick DASH Score dengan jenis kelamin dan diagnosa kanan atau kiri. Pembahasan: Terdapat perbedaan yang bermakna antara pasien fraktur metafise distal radius intraartikuler pada usia muda yang mendapat tindakan operatif berupa ORIF dengan yang mendapatkan tindakan non-operatif berupa pemasangan Gips.Kata kunci: Fraktur Metafise Distal Radius, Tindakan Operatif dan Non Operatif, Quick Dash ScoreAbstractFracture metafise distal radius is fracture with second highest incident on old age besides a fracture in the pelvic area. In the Dr. M. Djamil Hospital found 122 from 612 cases fracture of radius from january 2011 to june 2012. The main purpose therapy is restore the joint in the surface position anatomically by fixation a stable and restore the function upper extremitas over their best. Method: This study is a retrospective conducted at the Orthopaedi clinic of Dr M Djamil Hospital in November-December 2012 on young age patinet with the distal radius metafise intrartikular fracture who got the operative treatment in compare with non-operative groups with clinical assessment Quick Dash Score. The sample used is 30 people from 55 people who meet criteria for inclusion. Result: There is meaningful relationship the function upper extremitas with Quick Dash Score a distal radius fracture actions on intraartikuler at a young age that got an operative treatment and non-operative (p Fisher = 0,010 S). There is not meaningful relationships between Quick Dash Score with gender and diagnosis right or left. Discussion: There is significant difference between patients of intraarticuler radius distal metafise fractur who get operatif treatment, such as ORIF and the pasients who get non-operatif treatment, such as Gips.Keywords: Metafise Distal Radius Fracture, Operatif and Non Operatif Treatment, Quick Dash Score


2020 ◽  
Vol 99 (8) ◽  

Introduction: The study compares the results of open reduction using volar locking plates with ligamentotaxis by external fixation in fractures of distal radius type 2R3C according to AO classification. Methods: A retrospective study evaluating the results of osteosynthesis in patients with distal radius fractures type 2R3C according to AO classification, operated until December 2018. The ORIF method with volar locking plates (LCP) was used in 54 patients, and closed reduction with ligamentotaxis using external fixation (EF) was used in 33 patients. The mean age of the patients was 46.7 years in the LCP group and 59.6 years in the EF group. All were evaluated for their X-ray and functional outcomes and according to the Green and O’Brien score at 6 and 12 months after surgery. Results: According to X-rays at 12 months in the LCP group, the mean sagittal tilt was 10.13°, the mean radial inclination was 23.89°, and the mean radial length was 11.84 mm. In the EF group, the mean sagittal tilt was 6.32°, the mean radial inclination was 24.78°, and the mean radial length was 9.89 mm. According to the Green and O’Brien score, we recorded a mean score of 84.44 points in the LCP group at 12 month; we achieved good and excellent results in 83.33% of the patients and no poor result was observed. In the EF group the final mean score was 77.27; good and excellent results were achieved in 45.46% of the patients and a poor result in one patient. Conclusion: Based on the results in our group of patients, the internal type osteosynthesis using LCP implants can be recommended as a first-choice technique in the treatment of 2R3C fractures according to AO classification.


2014 ◽  
Vol 3 (62) ◽  
pp. 13736-13743
Author(s):  
Shaleen Sareen ◽  
Baljit Singh ◽  
Aditya Bhardwaj ◽  
Parminder Virdi ◽  
Simarpreet S Bhattal

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Pengbo Luo ◽  
Jinjie Lou ◽  
Shengwu Yang

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.


2006 ◽  
Vol 19 (4) ◽  
pp. 454
Author(s):  
Heun Guyn Jung ◽  
Jin Bae Choi ◽  
Seung Yong Seo ◽  
Yong Soo Choi

Author(s):  
Sunil Kumar Dash ◽  
Manish Kumar Sharma ◽  
Sanket Mishra ◽  
Hatia Marandi ◽  
Aurobinda Das ◽  
...  

<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>


Author(s):  
Graham Alastair

♦ Active treatment increasingly used♦ It is important to recognize type B fractures♦ CT useful to define complex fractures♦ K wiring quick and simple but complex fractures often require plating♦ Palmar locking plates useful for complex fractures♦ Dorsal plates only used occasionally because of complications.


Author(s):  
Siu Cheong Jeffrey Justin Koo ◽  
Kam Yiu Adrian Leung ◽  
Wai Wang Chau ◽  
Pak Cheong Ho

Abstract Background Distal radius fracture is one of the most common injuries. Poor functional result with restricted wrist motion can be developed when there is intra-articular fibrous tissue development arising from articular step-off and gapping. Objectives The aim of this study is to compare the functional and radiological outcome between arthroscopic-assisted reduction and fluoroscopic reduction in treating unstable intra-articular distal radius fracture. Methods We retrospectively analyzed 12 patients with intraarticular AO type C distal radius fracture treated with arthroscopic-assisted fracture reduction and internal fixation and compared them with another group of 12 patients in which fracture reduction is assessed by fluoroscopy alone (15 males and 9 females, mean age 57.3, range 27–73). The two cohorts were analyzed for differences in radiological parameters including articular stepping and gapping, palmar tilt, radial inclination, ulnar variance as well as functional outcome in range of motion, grip strength, modified mayo wrist score, and Quick Disabilities of the Arm, Shoulder, and Hand (DASH) score at an average of 12.5 months (range 5–26) after surgery. Results Arthroscopic-assisted fracture reduction group has statistically better restoration of articular stepping and gapping, volar tilt and ulnar variance. Range of motion, grip strength, modified mayo wrist score and Quick DASH score also had statistically significant improvement in arthroscopic group. Conclusion Our study showed arthroscopic-assisted technique can precisely restore radiological parameters in highly comminuted distal radius fracture with good functional outcome. Also, associated intra-articular soft tissue injury can be detected and treated simultaneously. Level of Evidence This is a level III, retrospective cohort study.


2020 ◽  
Vol 48 (01) ◽  
pp. 020-026
Author(s):  
Marcos Cruz-Sánchez ◽  
Jaime De la Torre-Rojo ◽  
Cristóbal Martínez-Andrade

Abstract Introduction Management of distal radius fractures remains controversial despite their high frequency. Elderly patients specifically present a high rate of secondary displacement, sometimes requiring a complex reconstructive surgery. The surgical treatment of displaced fractures evolving for several weeks in elderly patients has not been clearly reflected in the literature. This study aims to show clinical and radiological outcomes from this particular situation. Material and Methods Retrospective study of 31 cases of distal radius fractures with more than 2 weeks of evolution. Fractures were graded according to the Fernández's classification. Pre- and postoperative radiological studies were carried out to evaluate the degree of correction achieved. A clinical evaluation was performed using the Mayo Wrist Score. Data on arthroscopy and bone substitutes use, specific surgical tips and complications were also collected. Results Thirty-one patients with a mean age of 76 years old were operated for distal radius fracture with a delay in surgical treatment of 22 days. The most frequent fracture pattern was Fernández type III (38.7%). The clinical outcome according to the Mayo Wrist Score was 81.94 points with no relationship to fracture pattern or arthroscopic assistance. A statistically significant improvement was achieved for the correction of radial inclination, joint gap and ulnar variance. No statistically significant improvement was achieved in volar tilt correction. Complications were observed in 12.9% of the cases. Conclusions Delayed surgical treatment of distal radius fracture in elderly patients provides similar results to those observed in other age groups and time of evolution. Despite not being the ideal scenario for the surgeon, it should be considered to avoid functional deterioration in this fragile age group.


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