scholarly journals Results of open reduction and fixed angle locked volar plate fixation for fracture lower end of radius

Author(s):  
Gaurav Kumar ◽  
Varun Vijay

<p class="abstract"><strong>Background:</strong> The fracture of lower end radius is the most common fracture of upper extremity encountered in practice. Intra-articular fractures of distal radius present a challenging task to the operating surgeon. Open reduction and internal fixation using volar fixed-angle plates has shown to be a valid treatment option for unstable, dorsally displaced distal radial fractures. The present study was undertaken to evaluate the functional outcome of unstable distal radius fractures treated with fixed angle volar locking plate.</p><p class="abstract"><strong>Methods:</strong> The current study aimed at using fixed angle volar locking plate to treat unstable distal radius fractures. A total of 25 patients records were studied comprising of 19 males and 6 females with a mean of 44.5 years and followed up for a maximum of 1.5 year. Fractures were classified using the AO classification. The interpretation of functional outcome was done according to Mayo Wrist Score.<strong></strong></p><p class="abstract"><strong>Results:</strong> At final functional assessment, according to the Mayo wrist score, the scores of 6 patients were excellent, 10 patients good, 8 patients satisfactory and 1 patient poor. No non-union was reported in any patients. 3 patients developed minor complications in the form of superficial infection, hypertrophic scar and reflex sympathetic dystrophy and 1 patient developed major complication in the form of deep infection.</p><p class="abstract"><strong>Conclusions:</strong> Primary volar plate fixation of unstable distal radius fracture provides a stable construct that helps in early mobilization, better functional outcome and minimizes chances of complications and thereby is the treatment of choice for fracture distal end of radius.</p>

2011 ◽  
Vol 93 (1) ◽  
pp. 57-60 ◽  
Author(s):  
DC Perry ◽  
DMG Machin ◽  
JA Casaletto ◽  
DJ Brown

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.


2009 ◽  
Vol 58 (2) ◽  
pp. 283-286 ◽  
Author(s):  
Shoichi Kuba ◽  
Itaru Furuichi ◽  
Masakazu Murata ◽  
Takeshi Miyaji ◽  
Noriaki Miyata ◽  
...  

2013 ◽  
Vol 8 (2) ◽  
pp. 67-75 ◽  
Author(s):  
J. C. Goslings ◽  
Monique M. J. Walenkamp ◽  
Abdelali Bentohami ◽  
M. Suzan H. Beerekamp ◽  
Rolf W. Peters ◽  
...  

2005 ◽  
Vol 54 (3) ◽  
pp. 611-616
Author(s):  
Kazunobu Arakaki ◽  
Hikaru Tashima ◽  
Yosuke Asahara ◽  
Chikara Deguchi ◽  
Futoshi Kuga

2020 ◽  
Vol 09 (03) ◽  
pp. 219-224 ◽  
Author(s):  
Kamil Yamak ◽  
Hüseyin Gökhan Karahan ◽  
Berrak Karatan ◽  
Cemil Kayalı ◽  
Taşkın Altay

Abstract Background The aim of this study is to evaluate the frequency of flexor pollicis longus (FPL) tendon rupture and factors leading to this rupture during the follow-up of patients who underwent volar plate fixation because of distal radius fracture. Patients and Methods A total of 109 distal radius fractures of 102 patients treated with volar plate fixation and periodically followed up for at least 1 year between January 2013 and May 2018 were evaluated. Fractures were categorized according to the AO Foundation/Orthopaedic Trauma Association (AO/OTA) Fracture-Dislocation Classification and Soong's grading was used for classifying volar plate position. All patients operated were inquired retrospectively in terms of flexor tendon rupture. Results Gender distribution revealed 45 females and 57 males. Mean age was 47.9 (range: 17–88) years. Mean period of follow-up was 27 months. Distribution of fractures in accordance with the AO/OTA distal radius classification was 6, 8, 7, 12, 24, 33, 11, and 8 patients with types A2, A3, B1, B2, B3, C1, C2, and C3, respectively. When volar plate positions were analyzed with Soong's classification, it revealed that 79 (72.4%), 23 (21.1%), and 7 (6.5%) plates were grade 0, 1, and 2, respectively. In total, evaluating the three patients with FPL rupture, it revealed that the volar plate was positioned distally during fixation because the fracture line had advanced to the distal of the watershed line, the distal portion of the plate had lost complete connection with the bone, and at this portion, it was observed that the pronator quadratus muscle was not covering the plate entirely (Soong's classification grade 2). Patients did not have additional flexor tendon injury. Conclusion FPL tendon rupture is a rare but serious complication of volar plate fixation performed for distal radius fractures. We believe that appropriate choice of implant and careful surgical technique, along with the close follow-up of patients, with Soong's classification grade-2 volar positions would help in preventing this complication. Level of Evidence This is a Level 3a, differential diagnosis/symptom prevalence study.


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