Biomechanics and Biology of Plate Fixation of Distal Radius Fractures

Freeland, Alan E.; Luber, Kurre T.

doi:10.1016/b978-1-4160-4083-5.00062-7

Cited by 7 publications

(11 citation statements)

References 48 publications

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“…Numerous techniques for reducing and fixating distal radius fractures exist [5]. No single technique or system is appropriate for all fracture configurations.…”

Section: Discussionmentioning

confidence: 99%

Distal Radius Fractures and the Volar Lunate Facet Fragment: Kirschner Wire Fixation in Addition to Volar-Locked Plating

Moore

Dennison

2013

Hand (New York, N,Y.)

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Background The volar lunate facet fragment of a distal radius fracture may not be stabilized with volar-locked plating alone due to the small size and distal location of the fragment. Identification and stabilization of this small fragment is critical as unstable fixation may result in radiocarpal and radioulnar joint subluxation. The addition of spring wire fixation with volar plating can provide stable internal fixation of this critical fracture fragment. Methods A retrospective review (2006)(2007)(2008)(2009)(2010)(2011) identified nine patients with distal radius fractures with an associated volar lunate facet fragment that were treated with volar-locked plating and spring wire fixation of the volar lunate facet fragment. Radiographic indices, range of motion, grip strength, and postoperative Patient-related wrist evaluation (PRWE) scores were obtained to assess pain and function. Results All distal radius fractures healed, and the volar lunate facet fragment reduction was maintained. The mean follow-up was 54 weeks. Mean active range of motion was 46°wrist flexion, 51°wrist extension, 80°pronation, and 68°supina-tion. The mean grip strength was 21 Kg, achieving 66 % of the uninjured limb. The average PRWE score was 17. No patient required removal of hardware or had evidence of tendon irritation. Conclusions The addition of spring wire fixation to volarlocked plating provided stable fixation of the volar lunate facet fragment of distal radius fractures without complication. This technique addresses a limitation of volar-locked plating to control the small volar lunate facet fragment in distal radius fractures otherwise amenable to volar plating. Level of Evidence A retrospective case series, Level IV.

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“…Numerous techniques for reducing and fixating distal radius fractures exist [5]. No single technique or system is appropriate for all fracture configurations.…”

Section: Discussionmentioning

confidence: 99%

Distal Radius Fractures and the Volar Lunate Facet Fragment: Kirschner Wire Fixation in Addition to Volar-Locked Plating

Moore

Dennison

2013

Hand (New York, N,Y.)

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“…From the time surgical treatment distal end radius fractures started, they have been plated on the side of displacement: dorsally displaced fractures were plated dorsally, and volarly displaced fractures were plated volarly [8] . This approach allowed the placement of on the side of greater comminution as a buttress.…”

Section: Discussionmentioning

confidence: 99%

“…When addressing these very difficult fractures, it is important to stabilize each of these three columns [6] . Currently, the majority of intra-articular fractures of the distal radius are managed by the volar approach [7,8,9] . The majority of fractures of the distal radius can be managed in this manner.…”

Section: Introductionmentioning

confidence: 99%

Functional outcome of distal end radius fractures treated with periarticular locking plates

Bt¹,

Km²,

P³

2017

Int. J. Orthop. Sci.

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Introduction: Currently, the majority of intra-articular fractures of the distal radius are managed by the volar approach. It is useful to have a family of plates to address this complex fracture pattern from both a volar and dorsal approach. The purpose of this study is to asses the management of comminuted distal radius fractures with fragment specific plate fixation. Material and Methods:The study was a retrospective study conducted including two trauma centers, over a period of one year. The primary outcome was measured by Patient Rated Wrist Evaluation (PRWE) at 3 rd , 6 th &12 th month. Secondary outcomes were assessed with radiographic measures (shortening (ulnar variance), dorsal angulation, radial tilt, articular step) measured at presentation, postreduction and between 6 weeks and 12 months). Results: From a study population of 50 patients the study group showed 16% of type A, 36% of type B and 48% of type C fractures. At the 6 month follow-up, there was a mean of 15 0 of radial inclination, 2.5-mm radial shortening in 10 of the patients with type C fractures, no articular incongruity and a mean volar tilt of 3°. The score at 3 rd month ranged from 45 to 70 with the mean score of 57.2±8.52, the score at 6 th month ranged from 20 to 32 with the mean score of 25.3±3.6 and the score at 12 th month ranged from 0 to 12 with mean score of 6.18±3.11. Conclusion:The lack of deterioration of the radiological parameters and the consistent improvement of the PRWE scores underline the versatility and stability provided by the fragment specific plates. Thus through this study we have come to the conclusion that fragment specific plates show better functional outcome in distal end radius fractures.

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“…11,[14][15][16] The distal radius was fixed using a locking plate and screws, which provides very stable fixation with angular stability even in osteopenic bone. 37 The amount of callus formation partly depends on the stability of the fracture fragments, 38 with greater callus formation in unstable situations. 39 Also, while ALN should suppress bone resorption by osteoclasts, formation of osteoclasts or interaction between osteoclasts and osteoblasts is not prevented.…”

Section: Discussionmentioning

confidence: 99%

Effect of early administration of alendronate after surgery for distal radial fragility fracture on radiological fracture healing time

Uchiyama

Itsubo

Nakamura

et al. 2013

The Bone & Joint Journal

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Biomechanics and Biology of Plate Fixation of Distal Radius Fractures

Cited by 7 publications

References 48 publications

Distal Radius Fractures and the Volar Lunate Facet Fragment: Kirschner Wire Fixation in Addition to Volar-Locked Plating

Distal Radius Fractures and the Volar Lunate Facet Fragment: Kirschner Wire Fixation in Addition to Volar-Locked Plating

Functional outcome of distal end radius fractures treated with periarticular locking plates

Effect of early administration of alendronate after surgery for distal radial fragility fracture on radiological fracture healing time

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