Distal Radius Fracture Fixation with an Intramedullary Nail

Abstract

The purpose of this article is to describe a novel technique and implant system for fixation of unstable (Arbeitsgemeinschat fur Osteosynthesesfragen Types A and B) distal radius fractures. Currently the most common complications directly related to distal radius plate fixation includes tenosynovitis, tendon attrition, and rupture, often necessitating hardware removal. With the advent of this new device, a decrease in soft tissue complication is expected. The implant utilizes the principles of load sharing, subchondral screw divergence, and locked fixed-angle fixation. It is inserted through a small skin incision at the radial styloid and does not further devascularize the fracture fragments. The limited surgical dissection and rigid fracture fixation allow for minimal postoperative immobilization and an early return of function. The authors believe that this system is a valuable addition to the arsenal of distal radius fracture treatment options and can quickly get patients back on the road of recovery.

Comparative Analysis of Intramedullary Nail Fixation Versus Casting for Treatment of Distal Radius Fractures

“…Initial results of the Micronail fixation have been previously published, [3][4][5] but those studies contained relatively few patients, short follow-up periods, and/or no comparison group. The present study examined the differences between DRFs managed with closed treatment and open reduction with intramedullary fixation with follow-up of at least 1 year.…”

“…3 No bone grafting was used. In addition to the IMN, 1 patient with an open distal radioulnar joint (DRUJ) dislocation had capsular repair.…”

“…2 More recently, intramedullary fixation has also emerged as a viable treatment. [3][4][5] Even though DRFs are among the most common orthopedic injuries, the optimal treatment remains a topic of debate. It is generally agreed that stable fractures can be managed nonsurgically with satisfactory outcomes.…”

Intramedulläre Versorgung der distalen Radiusfraktur

“…Gute Ergebnisse der Frakturheilung und postoperativen Beweglichkeit für ein vergleichbares Implantat konnten bereits bei einer limitierten Patientenzahl festgestellt werden [13]. Jedoch zeigte auch die volare winkelstabile Plattenosteosynthese gute funktionelle Ergebnisse, die, abgesehen von den ersten 8 postoperativen Wochen, an die Ergebnisse mit dem Marknagel heranreichen konnten.…”

Biomechanical Stability of Four Fixation Constructs for Distal Radius Fractures

“…Dual-column fixation has been shown to have improved rigidity compared to dorsal plating and also has had demonstrated clinical success [6,14]. Recently, intramedullary fixation of distal radius fractures has been described to have acceptable clinical outcomes [2,18]. There has been a biomechanical assessment of the hybrid Dorsal Nail Plate™ (DNP; Hand Innovations, Miami, FL, USA) in comparison to volar locking plates [11].…”