Treatment of Displaced Intra-Articular Fractures of the Distal End of the Radius with Plates*

Fitoussi, Franck; Ip, WY; Chow, Sherman S. M.

doi:10.2106/00004623-199709000-00004

Cited by 182 publications

(120 citation statements)

References 16 publications

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“…Rogachefsky et al [4] also used external fixation in combination with dorsal and/or volar plating. Another study by Fitousi et al [18] examined type C1, C2, and C3 distal radius fractures. Combined dorsal/volar plating was used only 35% (12/34 patients) of the time.…”

Section: Discussionmentioning

confidence: 99%

“…These studies have produced a wide range of functional outcomes, including 45-65°for extension, 47-60°for flexion, 64-88°for supination, 68-82°for pronation, and 69-83% for grip strength compared to the contralateral side. Moreover, complication rates were as high as 26% [18]. These complications included problems with infections at the surgical site [2], infections at the K-wire site [3,4,18], extensor lag and rupture [2,18], median neuropathy [18], and wrist collapse leading to fusion [4].…”

Section: Discussionmentioning

confidence: 99%

“…The dorsal FCR sheath is then incised, and a superficial blunt retainer is used between the incised FCR tendon sheaths. The radial 17 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28) FCR sheath protects the radial artery, whereas the ulnar FCR sheath protects the median nerve. Once this is done, blunt dissection is carried down to the pronator quadratus muscle.…”

Section: Surgical Techniquementioning

confidence: 99%

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“Sandwich” Plating for Intra-articular Distal Radius Fractures with Volar and Dorsal Metaphyseal Comminution

Day

Kamath

Makhni

et al. 2007

Hand (New York, N,Y.)

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Introduction Intra-articular distal radius fractures with volar and dorsal comminution present a special challenge to the hand surgeon. Methods Ten patients formed the study cohort. All plates were low profile and stainless steel. Radiographic parameters, range of motion, and strength compared to the uninjured side were recorded. Functional outcome was evaluated by Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and Gartland and Werley scoring system. Results Median age at surgery was 58 years (range, 24 to 86). Mean follow-up was 17 months (range, 12 to 28). According to the AO classification system, there were three type C2 and seven type C3 fractures. Median preoperative dorsal angulation was 24 deg; median postoperative dorsal angulation was 3 deg. Eighty percent (8) of the fractures also had an intra-articular step-off or gap, all of which were corrected to neutral by the procedure. Compared with the contralateral side, mean extension and flexion were 73 and 75%, respectively, pronation and supination were 95 and 88%, respectively, and grip strength and thumb pinch were 72 and 87%, respectively. Mean postoperative DASH score was 16 points, and 70% (7) of the patients had Gartland and Werley scores of good or excellent. None of the patients needed to have their plates removed, and no extensor tendon rupture was reported. Conclusions The "sandwich" plating technique is an effective method of regaining near-anatomic reconstruction of intra-articular, volarly and dorsally comminuted distal radius fractures. Results from this study demonstrate that patients can expect to regain about 80% of their range of motion and strength. Moreover, 70% of the patients will have good to excellent functional outcomes. This is the first study to examine range of motion and functional outcome of low-profile "sandwich" plating without plate removal.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Surgical Techniquementioning

confidence: 99%

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“Sandwich” Plating for Intra-articular Distal Radius Fractures with Volar and Dorsal Metaphyseal Comminution

Day

Kamath

Makhni

et al. 2007

Hand (New York, N,Y.)

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“…Gartland Werley sı-nıflamasına göre Fitoussi ve arkadaşları %82, Gültekin ve arkadaşları %83 mükemmel-iyi sonuç bildirmiştir. [14,15] Figle ortalama DASH subjektif sorgulama puanını çalışmasında 25, Frattini ise 28,5 olarak vermiş-tir. [16,17] Fakat bu seride olguların kas güçleri ve grip kavrama güçleri sağlam tarafa göre anlamlı derece kötü bulunmuş, geri kazanım %43,1 olmuştur.…”

Section: Bulgularunclassified

“…Diğer serilerde geri kazanım %65 ile %85 arasında verilmektedir. [14][15][16][17][18] Bu durumu tekniğin yetersiz uygulanmasın-dan çok hastalara aynı fizyoterapist tarafından rutin fizik tedavi verilememesinden kaynaklandığını düşün-mekteyiz. Özellikle el rehabilitasyon üzerine özelleş-miş fizyoterapistlerin her klinikte bulunmaması erken ve iyi rehabilitasyonu engellemektedir.…”

Section: Bulgularunclassified

Volar plate fixation of distal radius fractures

Demirbaş¹,

Uğraş²,

Kaya³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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AMAÇErişkin radius alt uç kırıklarında volar yaklaşımla kilitli ve kilitsiz plak uygulamalarının sonuçları değerlendirildi. GEREÇ VE YÖNTEMDistal radius kırığı nedeni ile cerrahi tedavi uygulanan 34 hasta (14 kadın, 20 erkek; ort. yaş 48,5±17,9 yaş) geriye dönük olarak incelendi. Kırıkların tipi AO sınıflaması-na göre %17,6 B3, %11,8 C2 ve %70,6 C3 olarak dağılım göstermekteydi. Klinik sonuçlar Gartland ve Werley değer-lendirme skalası, Görsel analog ölçüt (VAS), kol omuz el sorunları anketi (DASH) ile, radyolojik değerlendirme ise Stewart değerlendirme ölçütleri ile yapıldı. BULGULARHastaların ortalama takip süresi 24±16,3 aydı. GartlandWerley değerlendirme skalasına göre hastaların %29,4'ünde mükemmel, %55,9'unda iyi, %11,8'inde orta ve %2,9'unda kötü sonuç alındı. Ortalama VAS skoru 0,5±1,1, ortalama DASH subjektif sorgulama puanı 26,1 olarak bulundu. Stewart skoruna göre %44,1 mükemmel, %52,9 iyi ve %2,9 orta sonuç elde edildi. Olguların kavrama gücü geri kazanımları sağlam tarafa göre %43,1 olarak bulundu. İki hastada kompleks rejyonel ağrı sendromu, bir karpal tünel sendromu ve bir tenosinovit görüldü. SONUÇRadius distal uç kırıklarının tedavisinde volar plak ile tespit etkin ve iyi bir yöntemdir. Plak uygun şekilde yerleştiril-meli ve ameliyat sonrası rehabilitasyon ihmal edilmemelidir.Anahtar Sözcükler: Distal radius kırığı; kilitli plak; plak fiksasyonu.

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