scholarly journals WHAT MUST BE THE VOLAR PLATE SCREW LENGTH TO PREVENT EXTENSOR TENDON INJURIES FOR DISTAL RADIUS FRACTURES FIXATION?

2021 ◽  
pp. 1
Author(s):  
BERKİN TOKER ◽  
TUNAY ERDEN ◽  
AYDIN RK
Keyword(s):  
Distal Radius ◽  
Extensor Tendon ◽  
Tendon Injuries ◽  
Distal Radius Fractures ◽  
Volar Plate ◽  
Radius Fractures ◽  
Screw Length ◽  
Extensor Tendon Injuries

EXTENSOR POLLICIS LONGUS TENDON RUPTURES AFTER THE USE OF VOLAR LOCKING PLATES FOR DISTAL RADIUS FRACTURES

Hand Surgery ◽  
2013 ◽  
Vol 18 (02) ◽  
pp. 169-173 ◽  
Author(s):  
Yukichi Zenke ◽  
Akinori Sakai ◽  
Toshihisa Oshige ◽  
Shiro Moritani ◽  
Kunitaka Menuki ◽  
...  
Keyword(s):  
Distal Radius ◽  
Tendon Injuries ◽  
Distal Radius Fractures ◽  
Locking Plates ◽  
Early Mobilisation ◽  
Radius Fractures ◽  
Extensor Pollicis Longus ◽  
Screw Length ◽  
Tendon Ruptures ◽  
Extensor Pollicis Longus Tendon

Currently, volar locking plates are commonly used to treat distal radius fractures (DRF) because of their stable biomechanical construct and because they cause less soft tissue disturbance and allow early mobilisation of the wrist. Complications such as rupture of tendons have been reported to occur with use of volar locking plates. We describe six cases of rupture of extensor pollicis longus (EPL) tendons after the use of volar locking plates. EPL tendon injuries occurred in 2.1% (6/286) of cases after DRF surgery. The causes of EPL rupture after DRF surgery were protrusion of the head tip and insufficient reduction of the dorsal roof fragment of the distal radius. These were considered iatrogenic problems. The cause of EPL rupture was unknown in three cases. We should be extremely careful when determining optimum screw length and reducing displaced dorsal roof fragments to prevent damaging the EPL tendons.

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.

scholarly journals Fixation Strength in Full and Limited Fixation of Osteoporotic Distal Radius Fractures

Hand ◽  
2017 ◽  
Vol 13 (4) ◽  
pp. 461-465 ◽  
Author(s):  
P. Kaveh Mansuripur ◽  
Joseph A. Gil ◽  
Dale Cassidy ◽  
Patrick Kane ◽  
Augusta Kluk ◽  
...  
Keyword(s):  
Distal Radius ◽  
Peak Load ◽  
Distal Radius Fractures ◽  
Volar Plate ◽  
Fixation Strength ◽  
Joint Surface ◽  
Clinical Failure ◽  
Radius Fractures ◽  
Yield Load ◽  
Load Peak

Background: The purpose of this investigation is to determine whether osteoporotic intra-articular distal radius fractures surgically treated by filling all 7 distal screws of a volar plate will have a higher load to failure than those treated by filling only 4 distal screws. Methods: Ten matched pairs of fresh frozen cadaveric forearms were randomized within each pair to be treated by using either all 7 of the distal holes of a volar plate or only 4 distal screws. The distal radius fixation was performed with unicortical screws going to but not through the dorsal cortex, and the most distal screws were placed within 4 mm of the joint surface. An AO C2 type fracture was then created. All specimens were tested cyclically, with an axial load of 60 N, at 3 Hz for 1000 cycles to simulate early postoperative motion. All specimens were subsequently tested to mechanical failure. Results: There were no failures in either group during cyclic testing. There was no difference detected between groups for mean stiffness, yield load, peak load, or load to clinical failure. In both groups, the yield load, peak load, and load to clinical failure were higher than the 60- to 100-N forces encountered during postoperative rehabilitation. Conclusions: There was no difference detected between osteoporotic intra-articular distal radius fractures treated by utilizing all 7 of the distal screws of a volar plate compared with those treated with only 4 distal screws.

Tendon Entrapment in Distal Radius Fractures

2009 ◽  
Vol 34 (4) ◽  
pp. 479-482 ◽  
Author(s):  
M. OKAZAKI ◽  
K. TAZAKI ◽  
T. NAKAMURA ◽  
Y. TOYAMA ◽  
K. SATO
Keyword(s):  
Clinical Features ◽  
Distal Radius ◽  
Flexor Tendon ◽  
Extensor Tendon ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Extensor Tendons ◽  
Epiphyseal Fracture ◽  
Tendon Entrapment

We retrospectively defined the rate and clinical features of tendon entrapment in 693 consecutive patients with 701 distal radius fractures treated in a single hospital. Eight extensor tendons and one flexor tendon were entrapped. All fractures with extensor tendon entrapment were palmarly displaced (Smith type) or epiphyseal. Flexor tendon entrapment was seen in dorsally angulated (Colles type) epiphyseal fracture. The rate of tendon entrapment in acute distal radius fractures was 1.3%. Extensor tendon entrapment in palmarly displaced fractures is more common.

scholarly journals Volar Plate Fixation with AO Distal Radius Plate (DRP) for Distal Radius Fractures

2005 ◽  
Vol 54 (3) ◽  
pp. 611-616
Author(s):  
Kazunobu Arakaki ◽  
Hikaru Tashima ◽  
Yosuke Asahara ◽  
Chikara Deguchi ◽  
Futoshi Kuga
Keyword(s):  
Distal Radius ◽  
Plate Fixation ◽  
Distal Radius Fractures ◽  
Volar Plate ◽  
Radius Fractures ◽  
Volar Plate Fixation

Distal radius fractures – A volar plate is not just a volar plate

Trauma ◽  
2017 ◽  
Vol 20 (3) ◽  
pp. 203-207
Author(s):  
Richard Knight ◽  
Lucy Elliott ◽  
Mark Brewster ◽  
Michelle Spiteri ◽  
Dominic Power
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Cost Savings ◽  
Fracture Pattern ◽  
Distal Radius Fractures ◽  
Volar Plate ◽  
Radius Fractures ◽  
Potential Cost ◽  
Plate Design ◽  
Column Variable

Introduction Increasingly complex distal radius plate designs are available for treating distal radius fractures. As a result, many fractures are being ‘over-treated’ with more complex volar plate designs than necessary. We hypothesise that significant cost savings could be made by rationalising the use of complex locking plate designs. Methods Over a two-year period, radiographs of 250 consecutive distal radius fractures fixed with volar locking plates were reviewed and the type of plate, and type and number of screws used for fixation were noted. Preoperative radiographs were independently reviewed to ascertain if it would have been possible to stabilise the fracture with a simpler, extra-articular plate design. Potential cost savings were then calculated. Results It was deemed that 89 (36.5%) of the 250 cases originally treated with a more complex 2 column variable angle plate could have been treated with an extra-articular construct, leading to potential savings of £19,224. Conclusion It is clear from our data that many distal radius fracture patterns are being ‘over-treated’ with complex locking plate designs with multiple rows of screws and that substantial cost savings could be made by selecting an appropriate construct to suit the fracture pattern.

scholarly journals Immobilization following Distal Radius Fractures: A Randomized Clinical Trial

2018 ◽  
Vol 07 (05) ◽  
pp. 409-414
Author(s):  
J. Hill ◽  
Gabriel Bouz ◽  
Ali Azad ◽  
William Pannell ◽  
R. Alluri ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Outcome Measures ◽  
Distal Radius ◽  
Plate Fixation ◽  
Distal Radius Fractures ◽  
Volar Plate ◽  
Dash Score ◽  
Radius Fractures ◽  
Volar Plate Fixation

Background No consensus exists regarding postoperative splinting position following volar plate fixation of distal radius fractures. Purpose The purpose of this study was to determine whether immobilization in supination would result in superior outcomes compared with no restriction of forearm range of motion. Patients and Methods All patients >18 years of age with distal radius fractures indicated for volar plate fixation were eligible. Exclusion criteria were open fracture and concomitant injury to, or functional deficit of, either upper extremity. Patients were randomized to immobilization in (1) maximal supination with a sugar-tong splint or (2) no restriction of supination with a volar splint. Patient-Rated Wrist Evaluation (PRWE), Disabilities of the Arm, Shoulder, and Hand (DASH) score, and visual analog scale (VAS) score; wrist range of motion; and grip strength were recorded at 2 and 6 weeks postoperatively. A Student's t-test was used to compare mean values of all outcome measures at each time point. Results A total of 46 patients enrolled in the study; 28 were immobilized with a volar splint and 18 were immobilized with a sugar-tong splint. Six-week follow-up data were obtained for 32 patients. There was no significant difference in PRWE, DASH, and VAS scores; or range of motion; or grip strength between the two groups postoperatively. Conclusion Range of motion, grip strength, and patient-rated outcome measures were similar regardless of postoperative immobilization technique in patients with a distal radius fractures stabilized with a volar plate. Surgeons can elect to use the standard-of-care postoperative immobilization modality of their preference following volar plate fixation without compromising short-term return to function. Level of Evidence This is a Level II, therapeutic study.

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