Minimally Invasive Plate Osteosynthesis for Distal Radius Fractures: Are There Any Advantages Against Conventional Technique?

MAXIMOV, B.I.; Максимов, Б И

doi:10.21823/2311-2905-2020-26-1-76-84

Cited by 2 publications

(1 citation statement)

References 24 publications

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“…Наряду со всеми преимуществами малоинвазивные доступы не обеспечивают достаточного обзора дистального отдела лучевой кости, что затрудняет проведение адекватной открытой репозиции при оскольчатых внутрисуставных переломах. Еще одним недостатком является отсутствие полноценной визуализации сухожилий мышц передней группы предплечья, что может привести к их прижатию платиной к кости с последующим функциональным дефицитом [20]. Новый доступ позволяет улучшить условия для операций на дистальном отделе лучевой кости, создает просторный и безопасный доступ, который позволяет сохранить мышечную часть квадратного пронатора и не нарушает анатомию синовиальных влагалищ сухожилий мышц передней группы предплечья, что является профилактикой развития дефицита ротационных движений предплечья и контрактур кисти и пальцев в раннем и позднем послеоперационном периодах.…”

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Experience in the Use of Surgical Access to the Distal Part of the Radius in Comminuted Intra-articular Fractures

Antoniadi,

Gordienko,

Gilev

et al. 2024

Урал. мед. журнал

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Introduction. Fractures of the distal radius occupy a leading place in the general structure of limb injuries. In most cases, they are comminuted in nature and require open reduction and ﬁxation. With traditional surgical approaches to the distal radius, there is a risk of injury to the tendons of the muscles of the anterior group of the forearm and the median nerve; in addition, the skin incision lines pass through the projection of the gap of the wrist joint, which leads to the formation of painful scars and diﬃculty moving in the early postoperative period.The purpose of the work is to evaluate the results of using a new surgical approach to the distal radius for the treatment of comminuted intra-articular fractures.Materials and methods. A retrospective analysis of the results of surgical treatment of 124 patients aged 19 to 78 years with a fracture of the distal radius for the period from 2015 to 2019 was carried out. A patient with a fracture of the distal epimetaphysis of the radius, Fernandez type III, underwent surgery through the proposed approach.Results. Aﬅer transosseous osteosynthesis with a distraction external ﬁxation device, on the sixth day, open reduction, bone graﬅing and plate osteosynthesis were performed through the proposed approach. Restoration of congruence of the articular surfaces of the wrist joint has been achieved. In the early postoperative period, movement in the joint is free, discomfort during the rehabilitation program is minimal. Aﬅer 12 months, movements in the joint are fully realized.Discussion. The new access makes it possible to improve the conditions for operations on the distal part of the radius with its fractures, creates a suﬃciently spacious and safe access to the radius, which allows you to preserve the muscular part of the square pronator and does not violate the anatomy of the synovial sheaths of the tendons of the muscles of the anterior forearm group, which is prevention of the development of deﬁciency of rotational movements of the forearm and contractures of the hand and ﬁngers in early and late postoperative periods.Conclusion. The developed new surgical approach to the distal radius provides optimalvisualization of the fracture andis low-traumatic, which has a positive eﬀect on restoring full range of motionin the wrist jointin the early stages aﬅer surgery.

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Section: Discussionunclassified

Experience in the Use of Surgical Access to the Distal Part of the Radius in Comminuted Intra-articular Fractures

Antoniadi,

Gordienko,

Gilev

et al. 2024

Урал. мед. журнал

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Functional and Radiographic Outcomes for Distal Radius Fractures Treated with Volar-Locked Plates and Percutaneous K-Wires: A Comparative Study

Egiazaryan

MAXIMOV

Askerov

et al. 2021

Traumatology and Orthopedics of Russia

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Abstract Purpose to evaluate and to compare radiological and functional outcomes of the volar locking plate fixation using pronator-sparing approach and K-wire fixation of distal radius fractures. Materials and Methods. We retrospectively analyzed 41 patients with distal radius fractures (27 female and 14 male) treated in the period from 2016 to 2020 using minimally invasive osteosynthesis via pronator-sparing approach. The mean age was 51 years (31-74 years). The control group consists of 37 patients (19 female and 18 male, mean age 61 years (29-76 years)), who underwent minimally invasive percutaneous K-wire fixation of distal radius fractures during the same period of time. Comparative analysis of radiographic and functional outcomes in both groups of minimally invasive osteosynthesis of distal radius fractures was carried out in the period from 1 to 6 months after the surgery. Results. Primary union of distal radius fractures was confirmed in X-rays in all patients within 6 weeks after the surgery. There were no complications in patientstreated by pronator-sparing volar locking plate fixation, whereas in K-wire group we had 6 patients with complications: 4 cases (11%) superficial infection around K-wires and 2 cases (5,4%) intraoperative damage of sensitive branch of radial nerve. There were statistically significant differences in radiographic results (volar tilt, radial inclination, andradial height) between two groups: they all were better in patients treated by pronator-sparing volar locking plate fixation during the whole follow-up period (р0,01). Minimally invasive volar locking plate fixation via pronator-sparing approach also provided significantly better grip strength and range of wrist motion and forearm rotation in the early 6-month postoperative period, compared with percutaneous K-wire fixation (р0,001). Conclusion. Our study demonstrates that both techniques of minimally invasive osteosynthesis of distal radius fractures are effective and relatively safe methodsof surgical treatment, but volar plating via pronator-sparing approach leads to a better reconstruction of the distal radius and better functional outcomes compared to percutaneous K-wiring. Keywords: minimally invasive osteosynthesis, distal radius, volar locking plate, pronator-sparing approach, K-wire.

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Minimally Invasive Plate Osteosynthesis for Distal Radius Fractures: Are There Any Advantages Against Conventional Technique?

Cited by 2 publications

References 24 publications

Experience in the Use of Surgical Access to the Distal Part of the Radius in Comminuted Intra-articular Fractures

Experience in the Use of Surgical Access to the Distal Part of the Radius in Comminuted Intra-articular Fractures

Functional and Radiographic Outcomes for Distal Radius Fractures Treated with Volar-Locked Plates and Percutaneous K-Wires: A Comparative Study

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