Radiographic Outcomes of Dorsal Distraction Distal Radius Plating for Fractures With Dorsal Marginal Impaction

Huish, Eric G.; Coury, John G.; Ahmed, Mohammed Ahmed Ibrahim; Trzeciak, Marc A.

doi:10.1177/1558944717704514

Cited by 15 publications

(36 citation statements)

References 15 publications

(22 reference statements)

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“…One patient had articular step-off greater than 2 mm, and no infections or tendon ruptures were reported. 23 The results of this study provide evidence supporting the use of additional instrumentation to aid in fracture reduction in patients with complex distal radius fractures. The study evaluated radiographic parameters at final follow-up but did not, however, compare immediate post-fixation reduction films and radiographic values to final follow-up, which we would argue is important to evaluate in considering the effectiveness of dorsal spanning plate fixation in maintaining fracture reduction over time.…”

Section: Discussionsupporting

confidence: 52%

Radiographic Outcomes following K-Wire Augmentation of Dorsal Spanning Plate Fixation for Intra-Articular Fractures of the Distal Radius

et al. 2021

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Background Restoration of articular surface alignment is critical in treating intra-articular distal radius fractures. Dorsal spanning plate fixation functions as an internal distraction mechanism and can be advantageous in the setting of highly comminuted fracture patterns, polytrauma patients, and patients with radiocarpal instability. The addition of K-wires to support articular surface reduction potentially augments fracture repair stability. Questions/Purposes We examined the radiographic outcomes and maintenance of reduction in patients with comminuted intra-articular distal radius fractures treated with K-wire fixation of articular fragments followed by dorsal spanning plate application. Patients and Methods We reviewed 35 consecutive patients with complex intra-articular distal radius fractures treated with dorsal spanning plate and K-wire fixation between April 2016 and October 2019. AO classification was recorded: B1 (3), B3 (2), C2 (2), C3 (28). A two-tailed paired t-test was used to compare findings immediately post-dorsal spanning plate surgery and at final follow-up after dorsal spanning plate removal. Results Mean patient age was 43.3 years (19–78 years). Mean follow-up was 7.8 months (SD 4.3 months) from surgery and 2.5 months from pin removal (SD 2.6 months). All patients achieved radiographic union. Radial height (mean interval change (MIC) 0.2 mm, SD 2.2, p = 0.63), articular step-off (MIC 0.1 mm, SD 0.6 mm, p = 0.88), and radial inclination (MIC −1.1 degrees, SD 3.7 degrees, p = 0.10) did not change from post-surgery to final follow-up. Ulnar variance (MIC −0.9 mm, SD 2.0 mm, p = 0.02) and volar tilt (MIC −1.5 degrees, SD 4.4 degrees, p = 0.05) were found to have decreased. Conclusion Dorsal spanning plate augmented with K-wire fixation for comminuted intra-articular distal radius fractures in polytrauma patients allows for immediate weightbearing and maintains articular surface alignment at radiographic union and may provide better articular restoration than treatment with dorsal spanning plate alone. Level of Evidence This is a Level IV, therapeutic study.

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Section: Discussionsupporting

confidence: 52%

Radiographic Outcomes following K-Wire Augmentation of Dorsal Spanning Plate Fixation for Intra-Articular Fractures of the Distal Radius

et al. 2021

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“…It is an internal fixator, which utilizes ligamentotaxis to help fracture reduction. Huish et al[ 21 ] applied a dorsal distraction plate to 19 complex distal radius fractures with dorsal marginal impaction. The mean radial inclination was 20.5°, the radial height was 10.7 mm, ulnar variance was -0.3 mm, volar tilt was 7.9°, mean plate removal time was 80.5 days, and all fractures united prior to plate removal.…”

Section: Discussionmentioning

confidence: 99%

Combined palmar and dorsal plating of four-part distal radius fractures: Our clinical and radiological results

Kibar

2021

Jt Dis Relat Surg

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Objectives This study aims to investigate the radiological and clinical outcomes of four-part intraarticular distal radius fractures treated with a volar anatomically locked plate and 2 mm low-profile plates using both the volar and dorsal approaches. Patients and methods This retrospective study included 20 patients (8 males, 12 females; mean age 47±12.1; range, 25 to 67 years) who received open reduction and internal fixation with combined volar and dorsal plating to treat complex four-part distal radius fractures (shaft, radial styloid area, dorsal medial facet, volar medial facet) between May 2016 and January 2019. According to Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification, all fractures were 2R3-C3. According to Melone classification, one fracture was type 1, seven fractures were type 2a, three were type 2b, three were type 3 and six were type 4. The mean follow-up time was 21±7.5 (range, 12 to 36) months. Results Union was achieved in all fractures. The mean tourniquet time was 103±12 (range, 90 to 130) minutes. The mean Disabilities of the Arm, Shoulder, and Hand questionnaire score was 10±9, and the mean Visual Analog Scale score was 2.1±0.9. According to Mayo wrist score, five patients had excellent, six had good, six had satisfactory and three had poor results. The mean grip strength was 25.2±9.2 (range, 15 to 40) kg and 78% of opposite side. Mean wrist flexion was 48.7°±15.3° (range, 30° to 80°), extension was 52.2°±17.2° (range, 25° to 80°), radio-ulnar deviation arc was 40.7°±6.9° (range, 30° to 55°), and mean forearm rotation arc was 152.3°±11° (range, 130° to 170°). Conclusion Plating method with a dual approach may be an alternative for four-part intraarticular distal radius fractures given its early mobility advantage and satisfactory functional and radiological results.

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“…Similarly, there is a consensus in the literature that arthroscopically assisted surgery positively affects the treatment of ligamentous injuries 18,19 . Furthermore, as we mentioned earlier, arthroscopically assisted surgery can contribute positively to these outcomes due to its positive effect on the intra-articular gap and step-off 4,5,8 .…”

Section: Discussionmentioning

confidence: 73%

“…Appropriate assessment of intra-articular reduction using fluoroscopy may be misleading compared with arthroscopy for plate and screw osteosynthesis techniques performed with a volar approach for fractures of the distal radius 6,7 . Some fracture patterns may not be suitable for volar plating 8 . Non-anatomic intra-articular reduction is a significant risk factor for chronic pain, limitation of motion, wrist instability, and radiocarpal osteoarthritis 9 .…”

Section: Introductionmentioning

confidence: 99%

Orta kolonu ilgilendiren distal radius kırıklarında artroskopik destekli fragman spesifik fiksasyon standart volar plak ile fiksasyona göre üstün müdür?

Çetin

Polat

Fidan

2022

Cukurova Medical Journal

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Purpose: In this study, the clinical and radiological results of volar plating and arthroscopic intervention-assisted fragment-specific fixation techniques used in patients operated for AO Type B-C distal radius fracture in which the medial colon is affected were compared. Materials and Methods: X-ray and clinical records of 98 patients who underwent surgical treatment for radius distal end (DER) fracture between April 2011 and January 2017. The patient groups treated with arthroscopy-assisted fragment-oriented fixation (Group A) and plate screw fixation with a volar approach without arthroscopic intervention (Group B) were compared in terms of joint range of motion, grip strength, and clinical scores. Flexion and extension, ulnar deviation, radial deviation, pronation, and supination angles measured with a standard goniometer were recorded in the joint range of motion measurement. Grip strength was measured with a Jamar dynamometer for power measurement. DASH score was used in clinical evaluation. Results: When the operated wrists of both patient groups were compared, there was no significant difference between the DASH score, grip strength, palmar flexion, and pronation angles of motion. A statistically significant difference was observed between the mean dorsiflexion angles of 55 degrees in group A and 44 degrees in group B, mean radial deviation angles of 25 and 19 degrees, and the mean supination angles of 87 and 80 degrees, respectively. Conclusion: Although arthroscopic-assisted fragment-specific fixation is technically a laborious procedure that requires a learning curve in patients with intra-articular distal radius fractures, it may be beneficial to provide better postoperative results, especially in young patients with high range of motion expectations.

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Radiographic Outcomes of Dorsal Distraction Distal Radius Plating for Fractures With Dorsal Marginal Impaction

Cited by 15 publications

References 15 publications

Radiographic Outcomes following K-Wire Augmentation of Dorsal Spanning Plate Fixation for Intra-Articular Fractures of the Distal Radius

Radiographic Outcomes following K-Wire Augmentation of Dorsal Spanning Plate Fixation for Intra-Articular Fractures of the Distal Radius

Combined palmar and dorsal plating of four-part distal radius fractures: Our clinical and radiological results

Orta kolonu ilgilendiren distal radius kırıklarında artroskopik destekli fragman spesifik fiksasyon standart volar plak ile fiksasyona göre üstün müdür?

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