scholarly journals Does the DVR® plate restore bony anatomy following distal radius fractures?

2014 ◽  
Vol 96 (1) ◽  
pp. 49-54 ◽  
Author(s):  
S Patel ◽  
PB Menéndez ◽  
FS Hossain ◽  
HB Colaço ◽  
MH Lee ◽  
...  
Keyword(s):  
Distal Radius ◽  
Normal Values ◽  
Fracture Type ◽  
Radius Fractures ◽  
Fixed Angle ◽  
Residual Functional ◽  
Radial Length ◽  
Bony Anatomy ◽  
Operating Surgeon ◽  
Functional Deficiency

INTRODUCTION Fractures of the distal radius are common. Malreduced fractures are associated with residual functional deficiency. There has been a trend over the last few years for using fixed angle volar locking plates to surgically stabilise this injury. Our unit uses the DVR® plate (DePuy, Warsaw, IN, US). Nevertheless, it is unknown whether the normal bony anatomy is recreated or merely restored to acceptable limits with its usage. The aim of this study was to evaluate the reduction achieved compared with an uninjured population and pre-existing quoted ‘normal’ values. Furthermore, we wanted to identify the percentage of cases that were reduced to acceptable limits, and determine whether the grade of the surgeon and fracture type was a confounding influence on this reduction. METHODS A retrospective review of the 3-month postoperative radiography of 48 eligible patients who underwent open reduction and internal fixation of a distal radius fracture with a DVR® plate was undertaken. RESULTS Volar tilt, radial length and inclination were different to quoted normal values (p<0.01). Despite this, these parameters fell within acceptable limits in 46 cases; this was not influenced by fracture type or grade of operating surgeon. CONCLUSIONS The DVR® plate restores the bony anatomy to within acceptable limits in the majority of patients who have sustained a fracture of the distal radius although of all parameters investigated, the widest variability is seen in volar tilt.

scholarly journals The Effectiveness of Closed Reduction Method Using Chinese Finger Trap and Immobilization of Circular Casts in the Management of Distal Radius Closed Fractures

2018 ◽  
Vol 1 (2) ◽  
pp. 46-53
Author(s):  
Clement Dewanto ◽  
Zulkarnain Muslim
Keyword(s):  
General Hospital ◽  
Distal Radius ◽  
Closed Reduction ◽  
Longitudinal Design ◽  
Distal Radius Fractures ◽  
Ulnar Variance ◽  
Fracture Type ◽  
Success Rates ◽  
Radius Fractures ◽  
Radial Length

ABSTRACT Introduction. Distal radius fractures are one of the most common fractures encountered by bone surgeons in the emergency room. In America, accounting for about 8% to 17% of all fracture cases that have been treated and around 75% of fractures in the forearm. In Palembang, especially in Dr. Moh Hoesin general hospital there was no data yet about the number of incidents of distal radius fractures, how to treat (conservatively or operatively) and success rates. For this reason it is difficult to measure accurately, how likely is it that a distal radius fracture can be successfully treated conservatively. Methods. This study was an observational analytic study with a longitudinal design to determine the effectiveness of closed reduction measures by immobilization casting through radiological examination in the management of cases of distal radius fractures at dr Moh Hoesin general hospital in Palembang Result. Based on the subject based on the type of fracture, there were 43.8% of subjects with Frykman-1; 6.3% of subjects with Frykman-2; 18.8% of subjects with Frykman-3; 12.5% ​​subjects with Frykman-4; 6.3% of subjects with Frykman-5; 0% of subjects with Frykman-6; 6.3% of subjects with Frykman-7; 6.3% of subjects with Frykman-8. Based on the analysis between the Fracture Type and X-Ray parameters in the form of Radial Length, Radial Inclination, Radial Tilt and Ulnar Variance, only Ulnar Variance has a significant relationship with p = 0.001 Conclusion. The effectiveness of closed reduction is significantly related to the type of Frykman fracture and the most fracture type that has been successfully closed closed is the type of Frykman I fracture with the highest number of samples and 100% success rate.

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.

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.

A Biomechanical Comparison of a Dorsal 3.5-mm T-Plate and a Volar Fixed-Angle Plate in a Model of Dorsally Unstable Distal Radius Fractures

2005 ◽  
Vol 19 (3) ◽  
pp. 187-191 ◽  
Author(s):  
Frank A. Liporace ◽  
Salil Gupta ◽  
Gerard K. Jeong ◽  
Michael Stracher ◽  
Fredrick Kummer ◽  
...  
Keyword(s):  
Distal Radius ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Fixed Angle ◽  
Biomechanical Comparison

COMPARISON OF RADIOLOGICAL AND CLINICAL OUTCOMES OF INTERNAL FIXATION USING TWO DIFFERENT VOLAR PLATES FOR DISTAL RADIUS FRACTURES

Hand Surgery ◽  
2014 ◽  
Vol 19 (03) ◽  
pp. 357-362 ◽  
Author(s):  
Chul-Hyun Cho ◽  
Si-Wook Lee ◽  
Gu-Hee Jung
Keyword(s):  
Clinical Outcomes ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Implant Design ◽  
Radius Fractures ◽  
Radial Length ◽  
Type C ◽  
The Mean ◽  
The Difference

The purpose of this study was to compare the outcomes of volar plating using two different implants for distal radius fractures. Fifty-two patients with AO type C fractures were placed in either of two groups: the AO LDRS group (26 patients) or the Acu-Loc group (26 patients). Radiological parameters including radial length, radial inclination, volar tilt, and intra-articular step-off were significantly improved after surgery. The mean Mayo Wrist Performance Score was 84.6 in the AO LDRS group and 81.1 in the Acu-Loc group. The mean Subjective Wrist Value was 86.7% in the AO LDRS group and 86.3% in the Acu-Loc group. There were no significant differences between the two groups with respect to both radiological and clinical outcomes at the final follow-up evaluation. Volar fixed-angle plating for unstable distal radius fractures had satisfactory radiological and clinical outcomes. The difference of implant design did not influence overall final outcomes.

DORSAL PLATING FOR COMMINUTED INTRA-ARTICULAR FRACTURES OF THE DISTAL END OF THE RADIUS

Hand Surgery ◽  
2004 ◽  
Vol 09 (02) ◽  
pp. 181-190 ◽  
Author(s):  
D. Osada ◽  
K. Tamai ◽  
A. Iwamoto ◽  
S. Fujita ◽  
K. Saotome
Keyword(s):  
Distal Radius ◽  
Open Reduction ◽  
Ulnar Variance ◽  
Radius Fractures ◽  
Radial Inclination ◽  
Articular Fractures ◽  
Radial Length ◽  
Comminuted Fractures ◽  
Dorsal Plating

Forty-one dorsally displaced intra-articular fractures of the distal radius were treated by open reduction and internal fixation with the dorsal Symmetry® plates. The average age at the time of the injury was 49 years. An average follow-up period was 15 months. The final radial length averaged 11 mm, radial inclination 23°, volar tilt 7°, ulnar variance 1.5 mm, and articular incongruity 0.3 mm. According to the Gartland and Werly scales, 36 fractures were excellent and five were good. However, ulnar variance increased more than 3 mm during follow-up in eight patients, and volar tilt increased more than 5° during follow-up in ten patients. Use of dorsal Symmetry® plate is effective for unstable comminuted intra-articular distal radius fractures, but severely comminuted fractures may possibly undergo re-displacement post-operatively.

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