scholarly journals Radiographic analysis in reduction loss after distal radius fracture fixation with variable angle volar locking plate

2020 ◽  
Author(s):  
Pin-Chieh Fang ◽  
Tak-Yu-Yubie Lo ◽  
Chun-Ying Cheng ◽  
Ying-Chao Chou ◽  
Alvin Chao-Yu Chen
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Fracture Fixation ◽  
Locking Plate ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
P Value ◽  
Volar Locking Plate ◽  
Radius Fractures ◽  
The Difference

Abstract Background Reduction loss is commonly seen even in the newly designed locking plate fixation for distal radius fractures. Our study purpose is to investigate the efficacy of the variable angle volar locking plate (VAVLP) in maintenance of fracture fixation. Methods A total of 37 patients of unilateral distal radius fractures receiving VAVLP fixation were included. Forearm radiographs immediately after surgery and those at 3 months were retrospectively reviewed for analysis of radiographic parameters including radial height (RH), ulnar variance (UV), radial inclination (RI), volar tilt (VT), tear drop angle (TDA), distal dorsal cortical distance (DDD) and Soong classification (SC). Results By comparing the 3-month measurement and normal data, the difference of RH/UV/TDA was significant (p-value < 0.001) while the difference of RI/VT was insignificant. However, there was no significant difference regarding those five parameters between postoperative and 3-month measurement. Linear regression on DDD exhibited positive dependence with p-value of 0.002 between postoperative and 3-month changes. Postoperative SC was grade 0 in 13 patients, grade 1 in 21, and grade 2 in 3. There were 7 of Gr 0 and 2 of Gr 1 making one grade up.Conclusion VAVLP fixation in distal radius fracture can maintain radiographic alignment without significant reduction loss for at least 3 months. Realignment within normal range was in RI and VT, but not in RH/UV/TDA.

scholarly journals Radiographic Analysis in Reduction Loss After Distal Radius Fracture Fixation with Variable Angle Volar Locking Plate

2020 ◽  
Author(s):  
Pin-Chieh Fang ◽  
Tak-Yu-Yubie Lo ◽  
Chun-Ying Cheng ◽  
Ying-Chao Chou ◽  
Alvin Chao-Yu Chen
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Fracture Fixation ◽  
Locking Plate ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
P Value ◽  
Volar Locking Plate ◽  
Radius Fractures ◽  
The Difference

Abstract Background Reduction loss is commonly seen even in the newly designed locking plate fixation for distal radius fractures. Our study purpose is to investigate the efficacy of the variable angle volar locking plate (VAVLP) in maintenance of fracture fixation. Methods A total of 37 patients of unilateral distal radius fractures receiving VAVLP fixation were enrolled. Forearm radiographs immediately after surgery and those at 3 months were retrospectively reviewed by orthopedist, radiologist and medical students for analysis of radiographic parameter including radial height (RH), ulnar variance (UV), radial inclination (RI), volar tilt (VT), tear drop angle (TDA), distal dorsal cortical distance (DDD) and Soong classification (SC). Results By comparing the 3-month measurement and normal data, the difference of RH / UV / TDA was significant (p-value of 0.000) while the difference of RI / VT was insignificant. However, there was no significant difference regarding those five parameters between postoperative and 3-month measurement. Linear regression on DDD exhibited positive dependence with p-value of 0.002 between postoperative and 3-month changes; predictability after modification was 21.3%. Postoperative SC was grade 0 in 13 patients, grade 1 in 21, and grade 2, in 3. There were 7 of Gr 0 and 2 of Gr 1 became one grade up.Conclusion VAVLP fixation in distal radius fracture can maintain radiographic alignment without significant reduction loss for at least 3 months. Realignment within normal range was in RI and VT, but not in RH / UV / TDA.

scholarly journals A COMPARATIVE STUDY OF VOLAR LOCKING PLATE VERSUS EXTERNAL FIXATION FOR DISPLACED INTRAARTICULAR DISTAL END RADIUS FRACTURES AT ORTHOPAEDICS DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

2021 ◽  
pp. 1-3
Author(s):  
Kunal Shankar ◽  
Vikash M. Harinandan ◽  
Laljee Chaudhary ◽  
Debarshi Jana
Keyword(s):  
External Fixation ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
External Fixator ◽  
Locking Plate ◽  
Plate Versus ◽  
Radius Fracture ◽  
Volar Locking Plate ◽  
Radius Fractures

Background: Distal radius fracture is more common accounting for 1/6th of the all fractures. With this background, this study was carried out to compare the functional outcome of volar locking plate and external fixator to the displaced intra-articular distal end radius fractures using Modified Mayo Wrist Score (MMWS). Materials and methods: This study included those patients with distal radius fracture attending the Orthopaedic Department of DMCH, Laheriasarai, Bihar, during January 2019 to December 2019. Patients were randomised based on - even and odd day of the week. This included two set of group with twenty patients in each group- one with volar locking plating and other with external fixation. Patients were followed up at 6 months and 1 year. At each follow up, the pain and range of movements were assessed by MMWS score which was entered in Microsoft excel and analysed in SPSS 20. Results: At the end of one year after surgery, we observed that external fixation technique was superior for treating displaced intra-articular comminuted distal end radius fractures than volar locking plate. Conclusion: External fixator showed more advantageous than volar locking plates after 1year of follow up.

INTRA-OPERATIVE CORRECTION OF VOLAR TILT OF DISTAL RADIUS FRACTURES USING VOLAR LOCKING PLATE AS REDUCTION TOOL: REVIEW OF 24 CASES

Hand Surgery ◽  
2014 ◽  
Vol 19 (03) ◽  
pp. 363-368 ◽  
Author(s):  
Sechachalam Sreedharan ◽  
Muhammad Farhan Mohd Fadil ◽  
Winston Shang Rong Lim
Keyword(s):  
Distal Radius ◽  
Fracture Fixation ◽  
Locking Plate ◽  
Distal Radius Fractures ◽  
Volar Locking Plate ◽  
Visual Estimation ◽  
Radius Fractures ◽  
Angular Correction ◽  
Surgical Fixation ◽  
Metaphyseal Comminution

In surgical fixation of distal radius fractures with metaphyseal comminution, volar tilt can be restored using an anatomical volar locking plate as a reduction tool. The purpose of our study is to assess the degree of over or under correction of volar tilt that can result with our 'lift' technique and to determine the ratio between theoretical and actual angular correction. We retrospectively reviewed 24 patients who underwent distal radius fracture fixation using this technique and assessed intra-operative radiographs for parameters including pre-'lift' and post-'lift' volar tilt and pre-'lift' plate-shaft angles. The ratio between actual angular correction and theoretical angular correction was calculated. The 'lift' technique is found to be reliable in restoring volar tilt in most fractures. Over- or under-correction does occur due to errors in visual estimation and actual angular correction is generally less than the theoretical angular correction.

Influence of Smoking in the Clinical Outcomes of Distal Radius Fractures

2020 ◽  
Author(s):  
Ayaka Kaneko ◽  
Kiyohito Naito ◽  
Hiroyuki Obata ◽  
Nana Nagura ◽  
Yoichi Sugiyama ◽  
...  
Keyword(s):  
Fracture Healing ◽  
Range Of Motion ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Bone Healing ◽  
Fracture Fixation ◽  
Healing Process ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
Radius Fractures

Abstract Introduction There are various studies that reviewed the effect of cigarette smoking in fracture healing process. Nonunion, delayed union, and residual pain are the significant risk factors associated with smoking and fracture healing. Little has been known about the impact of smoking in distal radius fracture healing. We intend to explore in brief the effect of smoking in distal radius fracture healing and comparing it with nonsmokers having the same fracture fixation and analyze the outcomes with respect to fracture healing and return of function. Materials and Methods Of the total 186 patients, 92 were included in the study with (n = male: 31, female: 61) mean age of 60.2 years. They were divided into two groups: smoking (n = 43) and nonsmoking (n = 49). All had surgical fixation of the distal radius with volar locking plate and started on early mobilization. The range of motion of the wrist, grip, visual analog scale, quick disabilities of the arm and shoulder and hand score, Mayo wrist score, and bone healing period were noted between these two groups and compared with statistical analysis. Results The mean follow-up period was 8.7 months. There was a significant association of young age and male patients having distal radius fractures in the smoking group (p < 0.05). All fractures healed well in both groups without complications. There was no significant difference between these two groups in terms of range of motion, grasp, bone healing period, and functional outcomes. Conclusion Despite the well-known fact that, smoking has negative implications in the fracture healing process, we found group of patients (smoking and nonsmoking) with distal radius fractures treated by volar locking plates healed well with good radiological union and excellent functional outcome There is no significant influence of smoking in distal radius fracture fixation.

scholarly journals Absence of Flexor Carpi Radialis Identified During Volar Approach for Fixation of Distal Radius Fracture: A Case Report

2021 ◽  
Vol 11 (3) ◽  
Author(s):  
Dharmesh Patel ◽  
Rajeev Vohra ◽  
Avtar Singh
Keyword(s):  
Case Report ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Locking Plate ◽  
Radius Fracture ◽  
Distal Forearm ◽  
Volar Locking Plate ◽  
Radius Fractures ◽  
Volar Approach ◽  
Flexor Carpi Radialis

Introduction: Volar locking plate fixation of distal radius fractures is commonly performed because of its good clinical outcomes. The flexor carpi radialis (FCR) approach is one of the most popular approaches to dissecting the volar side of the distal radius because of its simplicity and safety. We describe an extremely rare case of an absent FCR identified during a volar approach for fixation of a distal radius fracture. Case Report: A 40-year-old male with comminuted distal radius fracture underwent surgery using the usual FCR approach and volar locking plate. We could not identify the absence of the FCR tendon preoperatively because of severe swelling of the distal forearm. At first, we wrongly identified the palmaris longus (PL) tendon as the FCR because it was the tendinous structure at the most radial location of the volar distal forearm. When we found the median nerve just radial to the PL tendon, we were then able to identify the anatomical abnormality in this case. To avoid iatrogenic neurovascular injuries, we changed the approach to the classic Henry’s approach. Conclusion: Although the FCR approach is commonly used for fixation of distal radius fractures because of its simplicity and safety, this is the first report of complete absence of the FCR during the commonly performed volar approach for fixation of a distal radius fracture, to our knowledge. Because the FCR is designated as a favorable landmark because of its superficially palpable location, strong and thick structure, and rare anatomical variations, there is the possibility of iatrogenic complications in cases of the absence of the FCR. We suggest that surgeons should have a detailed knowledge of the range of possible anomalies to complete the fixation of a distal radius fracture safely. Keywords: Flexor carpi radialis, Anomaly, Distal radius fracture, Volar approach, Flexor carpi radialis approach.

Distal Radius Fracture Treatment Outcomes in Patients With Ipsilateral Hemiplegia or Hemiparesis

Hand ◽  
2021 ◽  
pp. 155894472199973
Author(s):  
Nicholas Munaretto ◽  
Adam Tagliero ◽  
Raahil Patel ◽  
Peter C. Rhee
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Case Series ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
Functional Classification ◽  
Radius Fractures ◽  
Radiographic Outcomes ◽  
Ipsilateral Hemiparesis

Background Little information exists to guide decision-making with regard to distal radius fractures in the setting of ipsilateral hemiparesis or hemiplegia. Methods Patients who sustained a distal radius fracture in the setting of ipsilateral hemiparesis or hemiplegia secondary to brain injury were evaluated. Investigated variables included perioperative pain, preinjury House functional classification score, length of immobilization, radiographic outcome measurements, and time to union. Results There were 15 patients with distal radius fractures with a mean age of 65.9 years. The mean clinical and radiographic follow-up was 2.8 and 2.9 years, respectively. Wrists were placed into the nonoperative group (NOG, n = 10) and operative group (OG, n = 5). Pain significantly decreased at final follow-up for both groups. Baseline House functional classification scores averaged 1.3 and 1.6 for the NOG and OG, respectively, and were maintained at final follow-up. Length of immobilization for the NOG was 46 days and OG was 37 days, P = .15. Radiographic outcomes at final follow-up in the NOG and OG, respectively, were a mean radial height of 9.3 versus. 11.6 mm, radial inclination of 18.3° versus 22.3°, 4.2° dorsal tilt versus 5.3° volar tilt, and tear drop angle of 45.6° versus 44.5°. There were no significant differences in these measurements. Time to radiographic union averaged 58 days for the NOG and 67 days for the OG, P = .42. There were no revision surgeries. Conclusions Based on this small case series, patients with distal radius fracture and ipsilateral hemiparesis or hemiplegia may have similar clinical, functional, and radiographic outcomes, regardless of nonoperative or operative treatment.

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