Comparison of volar and dorsal plate osteosynthesis for radial shaft fractures: an anatomical pilot study

Holweg, Patrick; Hohenberger, Gloria; Schwarz, Angelika; Silva, Mario; Krassnig, Renate; Grechenig, Stephan

doi:10.1016/s0020-1383(17)30737-4

Cited by 6 publications

(7 citation statements)

References 4 publications

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“…They concluded that plate contouring was necessary and precontoured plates would be desirable. 6 The dorsal precontoured plate, on the other hand, matched the anatomy much more reliably. In fact, at each plate segment, there was no statistical difference in plate offset from the bone comparing the precontoured with the surgeon-contoured plates.…”

Section: Discussionmentioning

confidence: 96%

“…[1][2][3][4][5] While fixation of an ulnar diaphyseal fracture can usually be performed with a straight plate, fixation of the radius often requires a plate contoured in the sagittal, coronal, and potentially axial planes, to match the 3-dimensional radial bow. [6][7][8] The standard plate used for adult diaphyseal forearm fractures is a 3.5 mm dynamic compression plate. Contouring this relatively rigid plate in 3 planes can be complex and time consuming.…”

Section: Introductionmentioning

confidence: 99%

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Level of Sagittal Plane Fit of Plates on the Radial Shaft: A Cadaveric Study Comparing Precontoured and Straight Titanium Plates

Jones

Stolle

Ilyas

et al. 2021

Hand (New York, N,Y.)

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Background: During radial shaft fracture fixation, it is important to contour the plate appropriately to restore the radial bow in order to maintain normal forearm mechanics and motion. The aim of this study was to investigate the fit of precontoured radial shaft plates versus surgeon-contoured plates. Methods: Six 10-hole Acumed® precontoured volar and dorsolateral radius plates and twelve 10-hole Synthes straight titanium 3.5 mm LC-DCP plates were drilled with arrays of 1.5 mm diameter holes to permit measurement of the plate distance off bone. Plates were applied to 6 cadaver radii and secured with a screw on each end. Three plate conditions were tested: precontoured plates, precontoured plates with further surgeon contouring, and straight plates with surgeon contouring. Surgeon contouring time for each plate was recorded. Each plate was divided into 3 equal regions, and the average distance gaps for each region and the entire plate were calculated. Results: For the volar side, precontoured plates had a larger total gap compared to that plate with additional surgeon contouring (1.4 mm difference) and the straight surgeon-contoured plates (1.2 mm difference). On the dorsal side, there was no difference in fit between the 3 plate conditions at any location. No differences were found in plate contouring times. Conclusions: The precontoured dorsal plate fit was as good as the surgeon-contoured plates indicating this plate could potentially be used in fracture surgery without further bending. The precontoured volar plate was under-contoured, on average, and would likely require further bending to restore the radial bow.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Level of Sagittal Plane Fit of Plates on the Radial Shaft: A Cadaveric Study Comparing Precontoured and Straight Titanium Plates

Jones

Stolle

Ilyas

et al. 2021

Hand (New York, N,Y.)

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“…The treatment method of choice for forearm diaphyseal fractures is ORIF. Therefore, the radius shaft can be reached through either Henry's or Thompson's approach for volar or dorsal plate osteosynthesis, respectively (Holweg et al, 2017). Thompson's approach is conducted through a dorsolateral incision on the forearm.…”

Section: Discussionmentioning

confidence: 99%

“…For this purpose, intramedullary stabilization may be performed (Saka et al, 2014); however, open reduction and internal fixation (ORIF) represents the treatment of choice. (Hughston, 1957;Anderson et al, 1975) Therefore, the radius shaft can be reached through either Henry's (volar) or Thompson's (dorsal) approach which enable exposition alongside the whole radial length (RL) (Holweg et al, 2017). However, the anatomy of the forearm is challenging, due to various muscles, nerves, and vascular structures, whereby some of these characteristics change position during forearm rotation.…”

Section: Introductionmentioning

confidence: 99%

The Important Relationship Between the Radial Artery's Course and the Radius during Henry's Anterior Forearm Surgical Exposure

Krassnig¹,

Hohenberger

Schwarz

et al. 2019

Clinical Anatomy

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The aim of this study was to investigate the intersection point of the radial artery (RA) with Henry's approach. Ninety forearms from adult human cadavers which had been embalmed using Thiel's method underwent dissection. Henry's approach was performed alongside the whole length of the forearm, and the RAs course was investigated. Its crossing point with the approach was identified, and the distance from this point to the radial styloid process was determined. In addition, the total radial length (RL) was measured from the radial styloid process to the proximal margin of the radial head. The former measurements were analyzed as proportions with regard to the total RLs. Concerning right radii, the intersection point was, on average, at a proportion of 56.2% of the radius, starting from the tip of the radial styloid process. In left radii, this was located at a mean proportion of 61.2%. In cases of multiply fractured radii, care must be taken at the interval between 40% and 80% to avoid RA lesions during dissection from distal to proximal. Clin. Anat., 33:983–987, 2020. © 2019 Wiley Periodicals, Inc.

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“…This is especially true of forearm diaphyseal fracture xation where the bowed radius rotates nearly 180° about the ulna [1,2]. Accordingly, incomplete reconstitution of the radial bow during fracture surgery in both location and magnitude has been linked to reduced forearm rotation and suboptimal functional outcomes as well as altered kinematics [3][4][5][6][7][8][9][10] A radius bone plate often requires contouring in the sagittal, coronal, and axial planes, to match the threedimensional radial bow [3,4,7,11,12]. The radius of curvature is most pronounced on the volar and dorsal aspects of the bone, corresponding with the two most common surgical approaches to a radial shaft fracture.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Level of Fit of Radial Fracture Fixation Plates Using Virtual and 3D-printed Models

Siegler

Stolle

Ilyas

et al. 2021

Preprint

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Radial fractures often require surgical stabilization with fracture fixation plates. Incomplete morphological reconstruction was linked to poor outcome such as limited forearm rotation. Pre-contoured plates are often used, but large inter-subject morphological variations may result in poor fit. Therefore, the goal of this study was to develop a reliable virtual measure of plate-to-bone fit. In addition, the study evaluated the accuracy with which 3D printed bones reproduce the morphology of the physical radius. Virtual models and 3D-printed models of six cadaver radii were produced from bone scans. Level of fit of pre-contoured plates were measured in three ways: directly on pre-contoured physical plates fitted to cadaver bone; pre-contoured physical plates fitted to 3D printed bone; and virtual plate models fitted to virtual bone models. In addition, the study evaluated the accuracy with which 3D printed bone reproduces the physical bone morphology. The results indicate excellent agreement between the physical and virtual level of fit measures as well as excellent geometrical accuracy of the 3D-printed bones. These provide the necessary foundation for guiding the development of better fitted pre-contoured fracture fixation plates as well as for developing pre-surgically patient specific pre-contoured plates.

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Comparison of volar and dorsal plate osteosynthesis for radial shaft fractures: an anatomical pilot study

Cited by 6 publications

References 4 publications

Level of Sagittal Plane Fit of Plates on the Radial Shaft: A Cadaveric Study Comparing Precontoured and Straight Titanium Plates

Level of Sagittal Plane Fit of Plates on the Radial Shaft: A Cadaveric Study Comparing Precontoured and Straight Titanium Plates

The Important Relationship Between the Radial Artery's Course and the Radius during Henry's Anterior Forearm Surgical Exposure

Evaluation of the Level of Fit of Radial Fracture Fixation Plates Using Virtual and 3D-printed Models

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