Palmar Fixation of Dorsally Displaced Distal Radius Fractures Using Locking Plates with Smartlock Locking Screws

Wong, T. C.; Yeung, C.C.; Chiu, Y.; Yeung, S. H.; Ip, F.K.

doi:10.1177/1753193408090129

Cited by 12 publications

(18 citation statements)

References 17 publications

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“…9,10,11,12,13,14,15,17) Furthermore, in our study, there were no mechanical complications such as irritations of flexor tendons or the median nerve. Some studies have reported on mechanical irritations after volar plate fixation 18,19,20).…”

Section: Discussionsupporting

confidence: 52%

“…They reported that 12 patients showed excellent results and 28 patients showed good results after a mean follow-up of 12 months, according to the Gartland and Werley scoring system. Wong et al11) reported the results from 35 patients with dorsally displaced distal radius fractures treated using the Stryker plating system with SmartLock locking screws after a mean follow-up of 10 months. The mean Mayo Clinic wrist score was 90 points and 20 patients achieved an excellent result.…”

Section: Discussionmentioning

confidence: 99%

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Korean Type Distal Radius Anatomical Volar Plate System: A Preliminary Report

et al. 2014

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BackgroundDistal radius fracture is the most common fracture of the upper extremity, and approximately 60,000 distal radius fractures occur annually in Korea. Internal fixation with an anatomical volar locking plate is widely used in the treatment of unstable distal radius fractures. However, most of the currently used distal radius anatomical plate systems were designed based on the anatomical characteristics of Western populations. Recently, the Korean-type distal radius anatomical volar plate (K-DRAVP) system was designed and developed based on the anatomical characteristics of the distal radius of Koreans. The purpose of this study was to evaluate the preliminary results of the new K-DRAVP system, and to compare its radiologic and functional results with those of the other systems.MethodsFrom March 2012 to October 2012, 46 patients with acute distal radius fractures who were treated with the K-DRAVP system at three hospitals were enrolled in this study. Standard posteroanterior and lateral radiographs were obtained to assess fracture healing, and three radiographic parameters (volar tilt, radial inclination, and radial length) were assessed to evaluate radiographic outcomes. The range of motion and grip strength, the Gartland and Werley scoring system, and the disabilities of the arm, shoulder and hand (DASH) questionnaire were used to assess clinical and functional outcomes.ResultsAll radiologic parameters were restored to normal values, and maintained without any loosening or collapse until the time of final follow-up. Grip strength was restored to 84% of the value for the unaffected side. The mean range of motion of the wrist at final follow-up was restored to 77%-95% of the value for the unaffected side. According to the Gartland and Werley scoring system, there were 16 excellent, 26 good, and 4 fair results. The mean DASH score was 8.4 points. There were no complications after surgery.ConclusionsThe newly developed K-DRAVP system could be used to restore and maintain good anatomical parameters, and provide good clinical outcomes with low complication rates. This system is a promising surgical option for the treatment of distal radius fractures in the Korean population.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Korean Type Distal Radius Anatomical Volar Plate System: A Preliminary Report

et al. 2014

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“…16,19 Reports are accumulating in the literature on the clinical and radiological performance of various palmar locking plates with broadly distributed qualities and subtle differences in specific implant characteristics. [1][2][3][4]6,7,[9][10][11][12]16 The multiplicity of reports in the literature and new implant designs results in more options for choosing an appropriate treatment strategy and, therefore, hints at an increased autonomy and potential for creativity in individual surgeons. Personal prefer- ence and experience should influence these considerations.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have reported that palmar plate fixation is an effective option for most types of distal radius fractures. [1][2][3][4][5][6][7][8] Using an interlocking fixation system results in good patient satisfaction and wrist function and restoration of physiological radius length and axis function. [1][2][3][4][9][10][11][12] Several analyses could not reveal that locking compression plates providing angular stability are superior in terms of biomechanical performance when compared with conventional nonlocking fixation systems.…”

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confidence: 99%

Locking Versus Nonlocking Palmar Plate Fixation of Distal Radius Fractures

Osti¹,

Mittler²,

Zinnecker³

et al. 2012

Orthopedics

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This study compared functional and radiological outcomes after treatment of extension-type distal radius fractures with conventional titanium nonlocking T-plates or titanium 1.5-mm locking plates. A total of 60 patients were included and followed for 4 to 7 years after receiving nonlocking T-plates (group A; n=30) or locking plates (group B; n=30) with and without dorsal bone grafting. Bone grafting was significantly more often performed in the nonlocking group to increase dorsal fracture fixation and stability (P<.003). Pre- and postoperative and follow-up values for palmar tilt, radial inclination, radial shortening, and ulnar variance were recorded. Age, sex, and fracture type were similarly distributed between the 2 groups. Postoperative and follow-up evaluation revealed equal allocation of intra-articular step formation and osteoarthritic changes to both groups. The overall complication rate was 25%. Compared with the nonlocking system, patients undergoing locking plate fixation presented with statistically significantly better values for postoperative palmar tilt (5.53° vs 8.15°; P<.02) and radial inclination (22.13° vs 25.03°; P<.02). However, forearm pronation was significantly better in group A (P<.005). At follow-up, radial inclination tended to approach a statistically significant difference in favor of group B. All clinical assessment, including Mayo wrist score, Disabilities of the Arm, Shoulder, and Hand score, Green and O'Brien score, Gartland and Werley score, visual analog scale score, and grip strength, yielded no statistically significant difference between the 2 groups. Locking plates seem to provide benefits regarding surgical technique and comfort, improvement in implant anchorage (especially in osteoporotic bone), and reduce the necessity of additional bone grafting.

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“…Complications have been reported due to overpenetration of screws through the dorsal cortex, intraarticular penetration and radial artery injury. Variable angle locking screws may help in prevention of joint penetration and interference with other hardware [107]. Fracture settling due to inadequate support of the subchondral bone by the distal screws can also occur [91,[108][109][110][111][112].…”

Section: Distal Radiusmentioning

confidence: 99%

The role of locking technology in the upper extremity

Joglekar

Ilyas

2016

J Hand Microsurg

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The technique of locked plating has been a major advance in Orthopaedic fracture surgery and has had an equal impact on the management of upper extremity fractures. The recognition of the role of vascularity and soft tissues in fracture healing was central to the research and development of newer plate designs that left minimal footprints on the surface of the bone. Subsequently, innovative locking technology has improved our ability to manage cases with extensive communition, inadequate bone stock, and peri-articular fractures. This paper will review the role of locking technology in the management of fractures of the upper extremity.

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Palmar Fixation of Dorsally Displaced Distal Radius Fractures Using Locking Plates with Smartlock Locking Screws

Cited by 12 publications

References 17 publications

Korean Type Distal Radius Anatomical Volar Plate System: A Preliminary Report

Korean Type Distal Radius Anatomical Volar Plate System: A Preliminary Report

Locking Versus Nonlocking Palmar Plate Fixation of Distal Radius Fractures

The role of locking technology in the upper extremity

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