Volar fixation for dorsally displaced fractures of the distal radius: A preliminary report

Orbay, Jorge L.; Fernández, Diego L.

doi:10.1053/jhsu.2002.32081

Cited by 535 publications

(396 citation statements)

References 16 publications

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“…These devices are designed to improve and maintain anatomic alignment even in patients with poor metaphyseal bone quality [9]. Initial reports of this technique by Orbay et al reported very few complications (3-4%) [9,10], but subsequent studies have indicated a higher complication rate. Rozental et al reported a 22% incidence of complications following fixation using a 2.4-mm LCP volar distal radius plate (Synthes, Inc, West Chester, PA) or distal volar radius plate (DVR™; Hand Innovations LLC, Miami, FL) [12].…”

Section: Introductionmentioning

confidence: 99%

Early Complications of Volar Plating of Distal Radius Fractures and Their Relationship to Surgeon Experience

Ward

Kuhl

Adams

2010

Hand (New York, N,Y.)

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Background Fractures of the distal radius are among the most common fractures in adults. Recently, there has been a trend towards open reduction and internal fixation of these fractures through a volar approach. The purpose of this study was to assess the early complications of volar locking plate fixation of distal radius fractures with an emphasis on defining the relationship between surgeon experience and incidence of complications. Materials and Methods Following IRB approval, we conducted a retrospective chart review of the initial 96 distal radius fractures (92 patients) treated by open reduction and internal fixation of distal radius fracture using a volar locked plate. Our outcome measurements were incidence of postoperative complications and radiographic loss of reduction. Results Twenty-two complications occurred in 21 patients. Of these, five complications (5%) required surgical treatment or hospitalization. Seventeen complications (18%) required no surgical intervention or hospitalization. Transient nerve dysfunction was the most common complication, accounting for 12 of 22 complications. The first 30 patients experienced significantly more complications than those treated later in the series (p=0.03). There was a trend towards increased incidence of complications in cases where more than 10 days elapsed between injury and surgery or where supplementary Kirschner wire fixation was used. There was no correlation between patient age, sex, severity of fracture, or presence of ulnar styloid fracture and the development of complications or loss of reduction. Discussion The incidence of complications decreased significantly with increased surgeon experience, suggesting that many of these early complications are avoidable.

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Section: Introductionmentioning

confidence: 99%

Early Complications of Volar Plating of Distal Radius Fractures and Their Relationship to Surgeon Experience

Ward

Kuhl

Adams

2010

Hand (New York, N,Y.)

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“…Following the introduction of fixed-angle volar plating for distal radius fractures, numerous reports have reflected good outcomes and have reported relatively few complications with respect to union, wound healing, or infection [2][3][4][6][7][8][9] in the general adult population. Compared to external fixation and dorsal techniques, the volar approach is advantageous as it avoids percutaneous pins and prolonged distraction across the radiocarpal joint and preserves the dorsal soft tissues in the region of the usual comminution.…”

Section: Discussionmentioning

confidence: 99%

Fixed-Angle Volar Plate Fixation for Distal Radius Fractures in Immunosuppressed Patients

Peterson

Dennison

2008

Hand (New York, N,Y.)

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The aim of this study was to define the outcome and complications following open reduction and internal fixed-angle plating of distal radius fractures for patients on chronic immunosuppression medications. A retrospective study identified 11 patients with distal radius fractures that had been on chronic immunosuppressive medication. The mean patient age was 59.9 years (40-82 years). According to the Orthopedic Trauma Association classification, there was one 23A3, one 23B3, and nine 23C type fractures.There were two open fractures. All patients received preoperative antibiotics and underwent reduction and fixation with a volar, fixed-angle plate. Postoperative measurements included postoperative and final radiographic indices, wrist flexion and extension, forearm rotation, and grip strength. Clinical follow-up averaged 13 months, and radiographic follow-up averaged 14.9 months. Statistical analysis was performed comparing means of various parameters with a two-sided t test with an alpha value ≤0.05. All fractures healed, and there were no infections. The final mean ulnar variance, volar tilt, and radial inclination were −0.1 mm (ulnar negative; −2.0 to +2.5 mm), 13°(5-23°), and 21°(15-27°), respectively. The mean articular gap or step was 0.4 mm. There was a small but significant decrease between the final and postoperative mean ulnar variance (p=0.03). Mean wrist flexion was 47°, extension 47°, pronation 77°, and supination was 76°. Grip strength averaged 16.3 kg versus 25.1 kg for the opposite extremity. The one major complication included a postoperative carpal tunnel syndrome. Fixed-angle volar plate fixation for distal radius fractures in patients with chronic immunosuppression was associated with union (with acceptable radiographic alignment), no wound-healing problems or infections, and with functional wrist and forearm motion and grip strength.

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“…This is a structure formed by the combined insertion of the tendon of the brachioradial muscle and the first extensor compartment (19) . This facilitates the release and future positioning of the metaphysis and epiphysis of the radius.…”

Section: Surgical Techniquementioning

confidence: 99%

Osteotomias do rádio distal com uso de placa volar de ângulo fixo

Oliveira¹,

Binz²,

Ferreira³

et al. 2012

Rev. bras. ortop.

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Objective: Skewed consolidation of the distal radius, due to sequelae of fractures, may cause functional incapacity, thus leading such patients to present pain, loss of strength and diminished mobility. Based on the excellent results obtained from surgical treatment of unstable fractures of the distal radius through a volar approach and use of rigid fixation with a fixed-angle volar plate, we started to use the same method for osteotomy of the distal radius. Methods: A retrospective review was conducted, and 20 patients treated between February 2002 and October 2009 were found. The mean length of follow-up was 43.9 months (range: 12 to 96 months). The surgical indications were persistent pain, deformity and functional limitation subsequent to a dorsally displaced fracture. Rev Bras Ortop. 2012;47(2):173-85Results: The mean preoperative deformity was 27º of dorsal tilt of the distal radius, 87º of ulnar tilt, and 7.3 mm of shortening of the radius. All the osteotomies consolidated and the final mean volar tilt was 6.2°, with ulnar tilt of 69.3° and shortening of 1 mm. The mean mobility of the wrist increased by 19.9° (flexion) and by 24° (extension). Mean forearm supination increased by 23.5° and pronation by 21.7°. Grip strength increased from 13.4 to 34.5 pounds. Conclusion: Use of a fixed-angle volar plate for a volar approach towards osteotomy of the distal radius enables satisfactory correction of the deformities and eliminates the need for removal of the synthesis material caused by tendon complications

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Volar fixation for dorsally displaced fractures of the distal radius: A preliminary report

Cited by 535 publications

References 16 publications

Early Complications of Volar Plating of Distal Radius Fractures and Their Relationship to Surgeon Experience

Early Complications of Volar Plating of Distal Radius Fractures and Their Relationship to Surgeon Experience

Fixed-Angle Volar Plate Fixation for Distal Radius Fractures in Immunosuppressed Patients

Osteotomias do rádio distal com uso de placa volar de ângulo fixo

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