Management of Comminuted Distal Radial Fractures Using Volar Plating versus External Fixation Augmented by K wires

2022 ◽  
Vol 86 (1) ◽  
pp. 420-426
Author(s):  
Usama Fawzy Attia ◽  
Mohamed El Soufy ◽  
Tarek ElHewala ◽  
Mohamed Adel Abdelrazek
Keyword(s):  
External Fixation ◽  
Volar Plating ◽  
Distal Radial Fractures ◽  
K Wires

scholarly journals Comparison of 2-year clinical and radiological outcomes between volar plating and external fixation with additional K-wires for AO Type C distal radius fractures

2019 ◽  
Vol 49 (5) ◽  
pp. 1418-1425
Author(s):  
Özgür ÇİÇEKLİ ◽  
Erhan ŞÜKÜR ◽  
Alauddin KOCHAİ ◽  
Levent BAYAM ◽  
İzzet BİNGÖL ◽  
...  
Keyword(s):  
External Fixation ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Volar Plating ◽  
Radius Fractures ◽  
Type C ◽  
K Wires

145 Outcomes of Unstable Distal Radius Fractures – A Meta-Analysis of Bridging External Fixation Versus Volar Plating

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
J Mulrain ◽  
K Joshi ◽  
F Doyle ◽  
A Abdulkarim
Keyword(s):  
External Fixation ◽  
Distal Radius ◽  
Plate Fixation ◽  
Meta Analysis ◽  
Distal Radius Fractures ◽  
Complication Rates ◽  
Volar Plating ◽  
Radius Fractures ◽  
Increased Risk

Abstract Introduction Distal radius fractures are common and trends for fixation have changed with increased use of volar locking plates in recent time. A meta-analysis will summarise the best evidence for treatment. Method A systematic review was conducted using PRISMA methodology to identify studies that reported clinical and/or radiological outcomes in patients with AO type C distal radius fractures when treated with external fixation versus ORIF. Results 10 randomised trials were included in this review, reporting on 967 patients. Clinical outcomes are in favour of volar plating at 3 months post-operation, but no difference between the two groups is seen at 6 or 12 months. Analysis of complication rates shows a minute increase in risk-ratio for volar plating versus external fixation. Subgroup analysis showed significantly higher re-operations after plate fixation and significantly higher infection after external fixation. Conclusions Internal fixation of complex distal radius fractures confers an improved clinical outcome at early follow up only and a minimally increased risk of complications. The improved grip strength with volar plating is only superior at early follow up and no long-term superiority is seen with either intervention. The type of surgery in this injury type therefore remains at the surgeon’s consideration on a case-by-case basis.

Volar plating versus external fixation for unstable dorsal fracture-dislocations of the proximal interphalangeal joint

2021 ◽  
pp. 175319342110593
Author(s):  
Atsuhiko Murayama ◽  
Kentaro Watanabe ◽  
Hideyuki Ota ◽  
Shigeru Kurimoto ◽  
Hitoshi Hirata
Keyword(s):  
External Fixation ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Volar Plating ◽  
Distal Interphalangeal Joint ◽  
Active Flexion ◽  
Plate Group ◽  
Fracture Dislocations ◽  
Distal Interphalangeal

We retrospectively compared the results of volar plating and dynamic external fixation for acute unstable dorsal fracture-dislocations of the proximal interphalangeal joint with a depressed fragment. We treated 31 patients (31 fingers), 12 with volar buttress plating and 19 with dynamic external fixation. Follow-up averaged 35 and 40 months in the two groups, with a minimal 6-month follow-up. Average active flexion of the proximal interphalangeal joint was 95° after plate fixation and 87° after external fixation, with an active extension lag of –6° and –9°, respectively. Active flexion at the distal interphalangeal joint averaged 67° in the plate group and 58° in the external fixation group, with active extension lags of 0° and –5°, respectively. We conclude that both methods can obtain a good range of motion at the proximal interphalangeal joint. A limitation of the extension of the distal interphalangeal joint occurred with dynamic external fixation but not with volar buttress plating. Level of evidence: IV

Three-dimensional dynamic AO external fixation of distal radial fractures — A preliminary report

Injury ◽  
1994 ◽  
Vol 25 ◽  
pp. SD85-SD89 ◽  
Author(s):  
J.C. Goslings ◽  
S. Tepic ◽  
A.H. Broekhuizen ◽  
R.P. Jakob ◽  
S.M. Perren
Keyword(s):  
External Fixation ◽  
Preliminary Report ◽  
Three Dimensional ◽  
Distal Radial Fractures

Methyl methacrylate in external fixation of supracondylar humerus fractures: An experimental study

2018 ◽  
Vol 232 (10) ◽  
pp. 1025-1029
Author(s):  
Ali Güleç ◽  
Mehmet Ali Acar ◽  
Bahattin Kerem Aydin ◽  
Teyfik Demir ◽  
Mustafa Özkaya
Keyword(s):  
Methyl Methacrylate ◽  
External Fixation ◽  
External Fixator ◽  
External Fixators ◽  
Three Point Bending ◽  
Fixation Methods ◽  
Supracondylar Humerus Fractures ◽  
Methacrylate Group ◽  
Humerus Fractures ◽  
K Wires

Supracondylar humerus fractures are common fractures around the elbow. Open fractures, comminuted metaphyseal fractures and also fractures with bone loss may need to be treated with external fixators. The aim of this study is to compare two different external fixators, tubular external fixators and polymethyl methacrylate with K wires external fixators, with regard to stiffness and stability for metaphyseal-diaphyseal osteotomies of distal humerus close to the joint. Six matched pairs (24 specimens) of second-generation sawbone humerus were prepared in a standard fashion to create a metaphyseal fracture, 5 cm proximal to the distal joint line of humerus and were randomly divided into two groups of 12 specimens each. Each sawbone humerus was osteotomized transversely at the mid-olecranon fossa with a 2-mm oscillating saw to simulate a Gartland type III fracture. The osteotomy was then reduced and stabilized using two different external fixation methods: carbon tubular external fixator with Schanz screws and methyl methacrylate with multiple K wires. Three-point bending and torsion tests were performed on the specimens. Bending and torsional stiffness of specimens were obtained for the fixation methods. According to the results of the study, the methyl methacrylate group has provided higher stiffness than classical tubular fixator with Schanz screws in three-point bending test (7.79 ± 2.33 N/mm vs 3.78 ± 1.18 N/mm, p = 0.006). The methyl methacrylate group also showed better stiffness in torsion test (0.12 ± 0.042 N m/° vs 0.067 ± 0.013 N m/°, p = 0.02). We determined for the first time in literature that external fixation with methyl methacrylate was significantly superior to the classical tubular external fixator with Schanz screws with regard to stiffness and stability under three-point bending and torsional loads. Moreover, methyl methacrylate is inexpensive and easily applied.

scholarly journals Early hybrid nonbridging external fixation of unstable distal radius fractures in patients aged ≥50 years

2019 ◽  
Vol 48 (4) ◽  
pp. 030006051987956
Author(s):  
Pengfei Cheng ◽  
Fan Wu ◽  
Hua Chen ◽  
Chaoyin Jiang ◽  
Ting Wang ◽  
...  
Keyword(s):  
Range Of Motion ◽  
External Fixation ◽  
Scale Score ◽  
Distal Radius ◽  
Visual Analog Scale Score ◽  
Dash Score ◽  
Radius Fractures ◽  
Analog Scale ◽  
Radial Inclination ◽  
K Wires

Objective We evaluated hybrid nonbridging external fixation (NBEF) supplemented by K-wires as an effective and safe treatment option for osteoporotic distal radius fractures (DRFs) in a retrospective case series. Methods Sixteen extra-articular and one intra-articular DRF were treated by NBEF from 2016 to 2018 (mean patient age, 61.8 years; 15 women, 1 man). Radiographic parameters (volar tilt, radial inclination, and ulnar variance), range of motion, grip power, the visual analog scale score, and the Disabilities of the Arm, Shoulder and Hand (DASH) score were assessed at 4 weeks, 6 weeks, 6 months, and 12 months postoperatively. Results The volar tilt and radial inclination were restored after surgery and maintained well. The mean visual analog scale score was 4 ± 1 at 4 weeks. Range of motion was restored to 79% to 91% at 6 weeks. The DASH score was good before NBEF device removal. Two superficial pin-tract infections were easily treated with antibiotics. Conclusions Hybrid NBEF transfixes DRFs in a multiplanar fashion, and augmentation with percutaneous K-wires provides direct fixation in radial shift and withstands axial loads in fracture fragments. It allows early mobilization with rigid fixation. Hybrid NBEF is reliable for unstable extra-articular and simple intra-articular DRFs in older patients. Clinical Study registration number ChiCTR1900021712

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