Distale Radiusfraktur – 20 Jahre winkelstabile Osteosynthese

Rudolph, Hans; Schmidt-Horlohé, Kay; Pichl, J.; Hoffmann, Reinhard

doi:10.1055/s-0032-1315300

Cited by 1 publication

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“…Dekade zählt sie mit 1107/100 000 Menschen bereits zu den häufigsten Frakturen überhaupt [2]. Die Einführung der winkelstabilen Platten hat zu einem Therapiewechsel geführt [3]. Instabile dislozierte Frakturen (AO-Klassifikation 23A3 und 23C) werden heutzutage überwiegend operativ versorgt.…”

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Ein neuer Zugang zur minimalinvasiven palmaren Plattenosteosynthese bei distaler Radiusfraktur

Chmielnicki

Prokop

2015

Z Orthop Unfall

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Distal radius fractures are among the most common fractures. Types A3 and C2 make up almost half of these. Volar fixed-angle plate fixation is the gold standard of treatment today. We wanted to minimise the approach to the distal radius through a transverse 2-3 cm incision in the wrist flexor fold, tunnelling beneath the pronator muscle. The operative technique is demonstrated here. 11 patients, averaging 70 years of age, underwent surgery for 7 A3 and 4 C2 type fractures. Average operating time was 50 minutes. Length of admission averaged 2.9 days. Using a visual analogue scale, pain decreased from 6/10 preoperatively to 3/10 on post-op day one and 2/10 on post-op day three. After 6 weeks, flexion and extension averaged 45-0-45°, and radial and ulnar deviation 20-0-20°. Pronation and supination averaged 85-0-85°. Grip strength with manometer averaged 90 % compared to the contralateral side at 6 weeks and 96 % at 3 months. As comparison, from 1 January 2008 until 31 May 2013, we treated 908 patients with distal radius fractures with volar fixed-angle plates through a conventional longitudinal incision of 5-8 cm. The average skin to skin time was 46 minutes, with an average length of admission of 5.6 days. A minimally invasive approach to treat distal radius fractures with volar plate fixation and sparing of the pronator muscle is possible. The initial patients treated with this approach experienced minimal post-operative pain, shorter hospital admissions, and rapid grip strength recovery with almost undisturbed rotational motion.

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