Size and stabilization of the dorsoulnar fragment in AO C3-type distal radius fractures

Miyashima, Yusuke; Kaneshiro, Yasunori; Yano, Koichi; Teraura, Hidetoshi; Sakanaka, Hideki; Uemura, Takuya

doi:10.1016/j.injury.2019.08.003

Cited by 17 publications

(18 citation statements)

References 20 publications

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“…A recent study by Miyashima et al found involvement of the dorsal ulnar facet fragment in 87% of AO type C3 fractures. 33 In our experience of managing complex intra-articular fractures, placing a volar locking screw in the dorsoulnar fragment in a comminuted unstable DRF can be technically challenging given the size of the fragment, often in combination with metaphyseal comminution. Combined plating offers the advantage of being able to reduce and stabilize the volar ulnar facet with the volar locking plate and thereafter addressing the dorsal fragments, including the dorsoulnar fragment, with the dorsal plate.…”

Section: Discussionmentioning

confidence: 99%

Combined Plating of Intra-Articular Distal Radius Fractures, a Consecutive Series of 74 Cases

2020

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Background: The distal radius fracture (DRF) is the most common fracture in adults. For unstable intra-articular fractures, the choice of treatment is often operative. The optimal choice of fixation remains a matter of discussion. Question/Purpose: Can combined volar and dorsal plating, using a dorsal frame plate, achieve a good functional and radiographic 1-year outcome in intra-articular DRFs? Methods: In a retrospective cohort study, we evaluated 74 consecutive patients operated with combined plating using a volar plate and a dorsal frame plate. The DRFs were operated between 2016 and 2017 and all cases were AO type C intra-articular fractures. The primary outcome was patient-reported outcome measures including radiographic examination 1 year postoperatively. Secondary outcome measures included wrist range of motion, visual analog scale (VAS) pain scores, and hand grip strength. Results: The median patient-rated wrist evaluation score was 18 points; the quick disabilities of the arm, shoulder, and hand score was 14.8 points. The median Batra radiographic score was 88. Wrist extension was 76% of the uninjured side, flexion was 74%, pronation was 94%, and supination was 94%. VAS pain scores were 0 at rest and 2 during activity. Hand grip strength was 82% compared with the uninjured side. The radiographic outcome according to Batra did not correspond to the patient-reported outcome. Patients older than 60 years had significantly better QuickDASH (quick disabilities of the arm, shoulder, and hand) and PRWE scores (patient-rated wrist evaluation scores) and less pain during activity compared with younger patients despite similar radiographic outcome. There were no tendon ruptures; hardware removal was performed in 21 of the 74 patients. Conclusion: The radiographic outcome did not correspond to the functional outcome 1 year postoperatively. Older patients report less pain and better functional outcome compared with younger patients. There were no tendon ruptures and the frequency of hardware removal was acceptable. Complex intra-articular DRFs AO type C can be managed with volar and dorsal frame-plate fixation to restore distal radius anatomy and achieve a good functional outcome.

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Section: Discussionmentioning

confidence: 99%

Combined Plating of Intra-Articular Distal Radius Fractures, a Consecutive Series of 74 Cases

2020

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“…In terms of image recording media, the traditional photosensitive film mode had been replaced by the CDD camera mode, and more advanced CMOS cameras had been gradually popularized and used [ 17 ]. With the continuous development and deepening of these new technologies, the current highest resolution of transmission electron microscopy and scanning electron microscopy had reached the high level of 0.07 nm and 0.4 nm, respectively [ 18 ].…”

Section: Literature Reviewmentioning

confidence: 99%

Postoperative Nursing and Functional Rehabilitation of Ultrasound Diagnosis of Lower Rotator Cuff Injury

Hou

2022

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In order to explore the postoperative nursing effect and functional rehabilitation of rotator cuff repair under ultrasound diagnosis, a method of nursing and rehabilitation functional training for athletes’ wrist injury under the assistance of microscopic B-ultrasound was proposed. This study retrospectively analyzed the therapeutic effect of tendon anastomosis in 237 patients with wrist tendon injury, adopted nursing measures such as health education and functional exercise, and observed its clinical effect. The results showed that after 3-6 months of follow-up, all patients had satisfactory recovery of tendon function. Of these, 132 patients recovered well. 84 patients recovered well. The excellent and good rate of patients was 91%. Ultrasound diagnosis of rotator cuff repair combined with functional exercise promotes good recovery of shoulder joint function in patients.

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“…13 To prevent postoperative displacement of a dorsal ulnar fragment, stabilization with at least 1 screw through a volar locking plate is necessary; however, the size of the DUC fragment is often small. 14 Combined plating can provide direct visualization of the DUC, which can facilitate reduction and stabilization of the DUC fragment and provide sufficient stability for early mobilization and good functional and radiographic outcomes in complex fractures. [15][16][17][18][31][32][33] The drawbacks of using combined plating include prolonged duration of surgery, more extensive soft tissue dissection, and tendon irritation from the dorsal plate.…”

Section: Discussionmentioning

confidence: 99%

“…13 In fractures involving the dorsal ulnar corner (DUC), the DUC fragment is often small and difficult to stabilize with a volar plate. 14 In these cases, volar plating can be combined with dorsal plate fixation (combined plating) as an option for reduction. 15 Combined plating has shown good outcomes and anatomical restoration but high frequencies of hardware removal and tendon ruptures.…”

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confidence: 99%

Volar Locking Plate Compared With Combined Plating of AO Type C Distal Radius Fractures: A Randomized Controlled Study of 150 Cases

Lundqvist

Fischer

Wretenberg

et al. 2022

The Journal of Hand Surgery

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Size and stabilization of the dorsoulnar fragment in AO C3-type distal radius fractures

Cited by 17 publications

References 20 publications

Combined Plating of Intra-Articular Distal Radius Fractures, a Consecutive Series of 74 Cases

Combined Plating of Intra-Articular Distal Radius Fractures, a Consecutive Series of 74 Cases

Postoperative Nursing and Functional Rehabilitation of Ultrasound Diagnosis of Lower Rotator Cuff Injury

Volar Locking Plate Compared With Combined Plating of AO Type C Distal Radius Fractures: A Randomized Controlled Study of 150 Cases

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