Minimally invasive percutaneous plate osteosynthesis for distal radius fractures with long-segment metadiaphyseal comminution

Wei, Xiaobo; Sun, Zhenzhong; Rui, Yongjun; Song, Xiao-jun; Jiang, Weimin

doi:10.1016/j.otsr.2015.12.024

Cited by 23 publications

(22 citation statements)

References 23 publications

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“…16,28 Two incisions, proximal and distal, are recommended in case of metadiaphyseal fracture. 20 Conversion to a conventional approach is always feasible in case of difficulties.…”

Section: Discussionmentioning

confidence: 99%

“…The proximal skin incision, through which are fixed diaphyseal screws, is always longitudinal and often shorter. The distal one is either longitudinal, 12,14 transverse, 13,15,[20][21][22][23] oblique, 27 or crescent-shape. 23 Some authors found that the transverse skin incision might bother some patients by being misinterpreted as a phlebotomy scar, 15 but they also claimed that it could be invisible if realized in a wrist crease.…”

Section: Discussionmentioning

confidence: 99%

“…been published since 2013 on this subject. [12][13][14][15][16][17][18][19][20][21][22][23] MIPO technique theoretically allows for faster bone healing 15 compared with a conventional Henry's approach 24,25 by preserving pronator quadratus, the periosteum around the fracture, and the blood supply. Cosmetic advantage is obvious.…”

mentioning

confidence: 99%

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Long Volar Plating for Metadiaphyseal Fractures of Distal Radius: Study Comparing Minimally Invasive Plate Osteosynthesis versus Conventional Approach

et al. 2017

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Minimally invasive plate osteosynthesis (MIPO) has been used in wrist surgery for several years. The purpose of this retrospective study was to compare clinical and radiologic outcomes of MIPO technique with those of a conventional approach in the treatment of metadiaphyseal distal radius fracture by long volar plating. Our series consisted of 32 fractures in 31 patients, mean age 63.9 years, including 16 men and 15 women. MIPO technique was used in 15 wrists (group 1) and conventional approach (> 60 mm of skin incision) in 17 wrists (group 2). In group 1, a long volar plate was inserted under pronator quadratus through a 15- to 30-mm distal incision then fixed to the epiphysis of the distal radius. Then, through a 15- to 30-mm proximal incision, the plate was fixed to the diaphysis of the radius, thus reducing the fracture. In group 1, mean distal incision size was 23.5 and 16.9 mm for proximal one. Mean total scar size (sum of both distal and proximal incisions) was 40.0 mm in group 1 and 84.1 mm in group 2. Mean tourniquet time was 58.4 minutes in group 1 and 68.9 minutes in group 2. At latest follow-up, no significant difference was noted in both the groups concerning pain, quick-DASH score, grip strength, ROM, and radiologic data. One extensor pollicis longus rupture treated by tendon transfer was done in group 1. The MIPO technique for metadiaphyseal fractures of the distal radius by long volar plating has cosmetic and economic advantages compared with the conventional approach. Conversion to conventional approach is possible at any time in case of technical difficulties. III.

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“…16,28 Two incisions, proximal and distal, are recommended in case of metadiaphyseal fracture. 20 Conversion to a conventional approach is always feasible in case of difficulties.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Long Volar Plating for Metadiaphyseal Fractures of Distal Radius: Study Comparing Minimally Invasive Plate Osteosynthesis versus Conventional Approach

et al. 2017

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“…(3) In recent years, there has been an increasing trend towards minimally invasive surgical techniques. (4) One example is the minimally invasive percutaneous plate osteosynthesis technique for distal radius fractures, (5,6) which uses a transverse wrist incision. The procedure was found to have similar functional outcomes as the traditional longitudinal approach.…”

Section: Introductionmentioning

confidence: 99%

“…However, these studies excluded fractures that were open, multifragmentary, intra-articular, involved neurovascular compromise, had concomitant upper extremity injury or involved systemic multiorgan trauma. (6)(7)(8) For fractures that are amenable to fixation with a transverse approach, the main benefit is that it allows the scar to blend in with the wrist crease and is less noticeable, unlike the longitudinal scar from the traditional Henry approach. (7) Endoscopic carpal tunnel release is performed using a transverse volar wrist crease incision, with varying degrees of patient satisfaction based both on appearance of the scar as well as postoperative pain when compared to the longitudinal open carpal tunnel approach.…”

Section: Introductionmentioning

confidence: 99%

Transverse or longitudinal? A survey of volar wrist incision preferences

Siow¹,

Tong²,

Satku³

et al. 2020

smedj

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Introduction:In volar wrist surgery, the traditional longitudinal incision leaves a scar that may be considered cosmetically unpleasant. Recent studies suggest that transverse wrist incisions result in more aesthetically pleasing scars that are well hidden in the wrist crease. The aim of our study was to explore the public's perceptions of longitudinal versus transverse wrist scars. Methods:A prospective survey was conducted among the general public. Inclusion criteria were patients aged over 18 years with no prior surgery to the wrist. Survey questions assessed included: (a) longitudinal or transverse scar preference; (b) reasons for preference; and (c) demographic information. Results: There were 107 respondents from the general public. More respondents preferred longitudinal scars. Top three reasons for longitudinal scar preference were: (a) perceived damage to wrist structures by a transverse incision; (b) better cosmesis; and (c) scar from the transverse incision appearing like a self-inflicted injury. Top three reasons for transverse scar preference were: (a) easily concealed by accessories; (b) less noticeable; and (c) better cosmesis. Respondents aged 60 years and above were most concerned about possible damage to wrist structures; younger respondents were most concerned that transverse scars appeared like self-inflicted injuries. Conclusion: Respondents from the general public preferred a longitudinal scar to a transverse one. Younger respondents were most concerned about how the transverse scar appeared like a self-inflicted injury while older respondents were most concerned with perceived functional implications of the incisions.

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Pharmacological interventions for the prevention of bleeding in people undergoing definitive fixation or joint replacement for hip, pelvic and long bone fractures

Gibbs

Champaneria

Geneen

et al. 2023

Cochrane Database of Systematic Reviews

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Background Pelvic, hip, and long bone fractures can result in significant bleeding at the time of injury, with further blood loss if they are treated with surgical fixation. People undergoing surgery are therefore at risk of requiring a blood transfusion and may be at risk of peri‐operative anaemia. Pharmacological interventions for blood conservation may reduce the risk of requiring an allogeneic blood transfusion and associated complications. Objectives To assess the effectiveness of different pharmacological interventions for reducing blood loss in definitive surgical fixation of the hip, pelvic, and long bones. Search methods We used a predefined search strategy to search CENTRAL, MEDLINE, PubMed, Embase, CINAHL, Transfusion Evidence Library, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform (ICTRP) from inception to 7 April 2022, without restrictions on language, year, or publication status. We handsearched reference lists of included trials to identify further relevant trials. We contacted authors of ongoing trials to acquire any unpublished data. Selection criteria We included randomised controlled trials (RCTs) of people who underwent trauma (non‐elective) surgery for definitive fixation of hip, pelvic, and long bone (pelvis, tibia, femur, humerus, radius, ulna and clavicle) fractures only. There were no restrictions on gender, ethnicity, or age. We excluded planned (elective) procedures (e.g. scheduled total hip arthroplasty), and studies published since 2010 that had not been prospectively registered. Eligible interventions included: antifibrinolytics (tranexamic acid, aprotinin, epsilon‐aminocaproic acid), desmopressin, factor VIIa and XIII, fibrinogen, fibrin sealants, and non‐fibrin sealants. Data collection and analysis Two review authors independently assessed trial eligibility and risk of bias, and extracted data. We assessed the certainty of the evidence using GRADE. We did not perform a network meta‐analysis due to lack of data. Main results We included 13 RCTs (929 participants), published between 2005 and 2021. Three trials did not report any of our predefined outcomes and so were not included in quantitative analyses (all were tranexamic acid versus placebo). We identified three comparisons of interest: intravenous tranexamic acid versus placebo; topical tranexamic acid versus placebo; and recombinant factor VIIa versus placebo. We rated the certainty of evidence as very low to low across all outcomes. Comparison 1. Intravenous tranexamic acid versus placebo Intravenous tranexamic acid compared to placebo may reduce the risk of requiring an allogeneic blood transfusion up to 30 days (RR 0.48, 95% CI 0.34 to 0.69; 6 RCTs, 457 participants; low‐certainty evidence) and may result in little to no difference i...

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Minimally invasive percutaneous plate osteosynthesis for distal radius fractures with long-segment metadiaphyseal comminution

Abstract: Therapeutic IV.

Cited by 23 publications

References 23 publications

Long Volar Plating for Metadiaphyseal Fractures of Distal Radius: Study Comparing Minimally Invasive Plate Osteosynthesis versus Conventional Approach

Long Volar Plating for Metadiaphyseal Fractures of Distal Radius: Study Comparing Minimally Invasive Plate Osteosynthesis versus Conventional Approach

Transverse or longitudinal? A survey of volar wrist incision preferences

Pharmacological interventions for the prevention of bleeding in people undergoing definitive fixation or joint replacement for hip, pelvic and long bone fractures

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