Is Pronator Quadratus Affected In Volar Approach To Distal Radius Fractures?

Background: The aim of this study was to compare the functional outcomes and complications of volar and dorsal plating for the management of intra-articular distal radius fractures, with special regard to indications for dorsal plating. Furthermore, we examine the rationale for choosing dorsal plating and its frequency of use. Methods: Clinical assessments included range of motion measurements at the wrist; grip strength; the Quick Disabilities of the Arm, Shoulder, and Hand score; and the Gartland and Werley score. Clinical results were compared with those achieved using a volarly placed locking plate system. According to Lutsky’s plate theory, the rationale for choosing dorsal plating was based on 4 types of pathologic fractures. Results: Of 112 patients, 38 patients were treated with open reduction internal fixation via a dorsal approach and 68 patients were treated using a volar approach. Except for wrist flexion, there were no other statistical differences in the clinical results between groups for both subjective and objective parameters. There were no statistically significant differences in the complication rates between the volar and dorsal plated groups. One serious complication occurred after volar plating. The most common reason for choosing dorsal plating was irreducible dorsal die-punch fractures. Conclusions: The treatment of displaced intra-articular distal radius fractures with a dorsally versus a volarly placed interlocking plate system demonstrated similar clinical results. Postoperative complications were not readily observed in the patients treated with a dorsal locking plate. Certain fracture patterns are more appropriately stabilized using a dorsal plate fixation.

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Correlation of clinical and radiological outcome of distal radius fractures treated with volar plating

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20212813 ◽

2021 ◽

Author(s):

Rajath H. P. Gowda ◽

Ravi M. Daddimani ◽

Srinath K. Madhava Murthy

Keyword(s):

Distal Radius ◽

Wrist Joint ◽

Excellent Result ◽

Young Patients ◽

Distal Radius Fractures ◽

Radiological Outcome ◽

Volar Plating ◽

Radius Fractures ◽

Anatomical Reduction ◽

Volar Approach

Background: Distal radius fractures are one of the most common injuries treated by an orthopaedic surgeon, accounting for approximately one sixth of all fractures. Due to increase in incidence of high velocity trauma, the injury is seen occurring in young patients more often. A displaced fracture deranges the wrist anatomy causing deformity and loss of function at the wrist joint. Open reduction and internal fixation with plate using a volar approach allows anatomical reduction of the fracture, stable fixation aiding in early mobilization.Methods: Our study was a hospital-based study conducted during the period June 2016 to November 2018. A total of 30 patients with distal radius fracture were treated with ORIF with a volar plate. They were followed up for a year and clinical and radiological outcomes were evaluated.Results: Among the 30 patients studied 25 were males and 5 were females with mean age of 36.23 years. According to Gartland and Werley demerit scoring system, 15 of them had excellent result at the end of one year. 13 Of them had good and 2 of them had fair results. Radiological assessment was done by Sarmiento’s modification of the Lind storm criteria and 15 of them had excellent results. 15 patients had good radiological outcome.Conclusions: From this study we conclude that ORIF with volar plating can provide good clinical and functional outcome in distal radius fractures. Anatomical reduction of the fracture fragments is the key in achieving good results.

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1224 Effect of Distal Brachioradialis Release During Open Reduction and Internal Fixation of Distal Radius Fractures

British Journal of Surgery ◽

10.1093/bjs/znab259.1033 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

A Hafez ◽

A Shaat ◽

M Zain ◽

M A Sajid ◽

A Butt

Keyword(s):

Internal Fixation ◽

Distal Radius ◽

Open Reduction ◽

Group Versus ◽

Distal Radius Fractures ◽

Radius Fractures ◽

Volar Approach ◽

Normal Ranges ◽

Significant Difference ◽

The Impact

Abstract Aim The study aim is to determine the impact of the brachioradialis release during the open reduction and internal fixation of distal radius fractures using a volar approach Method Total of 40 patients was treated with Open reduction and internal fixation of intra articular distal radius fractures. Distal release of Brachioradialis was performed to 19 patients, while 21 patients had no release of BR during surgery. Radiological parameters including Radial height, Inclination and volar tilt were measured 1 month post-operatively, while functional outcomes assessed with modified mayo wrist scores and Quick-dash scores Results There is no significant difference between age, gender and pre-operative conditions indicating that both the groups (BR release and without BR release) have similar demographic characteristics. Pre-operatively both groups had disturbed values for radial height, inclination, and volar tilt. Postoperatively, the mean of both groups was closer to normal ranges for radial inclination and volar tilt; however, radial height was the least adequately restored radiological parameter for both study group (11.54 ± 1.35 for BR group versus 10.21 ± 2.29 for Non-BR group). Pain, functional status, and grip strength had similar values in both groups whereas BR group showed higher ROM and DASH scores with P values of 0.048 and 0.025 respectively. Conclusions Brachioradialis release enhances the reduction and operative fixation, restoring the necessary radiological and subsequent functional parameters in distal radius fractures with reported no complications.

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