Volar locking plate fixation for distal radius fractures: Does age affect outcome?

Ezzat, Ahmed; Baliga, Santosh; Carnegie, C.; Johnstone, Alan J.

doi:10.1016/j.jor.2016.01.001

Cited by 6 publications

(7 citation statements)

References 30 publications

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“…The higher percentage of female patients in the volar plate group than in the intramedullary nail group in our study may be important in terms of better restoration of radio-ulnar variance in females, given their higher likelihood of reduced bone density and the association of osteoporotic bone fractures with higher likelihood of ulna shortening after fracture, as well as better ulna deviation postoperatively in distal radius factures treated with volar plate fixation [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…This seems consistent with potential clinical and biomechanical benefits of minimally invasive intramedullary nail fixation, including load transfer across the fracture site, minimized risk of soft tissue disruption and irritation, and less postoperative adhesion formation, decreased postoperative pain, and promoted fracture healing [ 7 , 24 , 53 ]. Notably, volar plate fixation has also consistently been associated with favorable radiological and clinical outcomes in past studies among patients with distal radius fractures [ 8 , 9 , 12 – 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Volar locking plate fixation is increasingly used in treating distal radius fractures, given its advantages over standard volar fixation because it provides stable fixation, even in comminuted fractures of osteoporotic bone [ 8 , 9 ], it has a lower rate of complications than dorsal fixation [ 10 , 11 ], and many studies of patients with distal radius fractures showed favorable radiological and clinical outcomes, with early mobilization and rapid recovery and improved wrist function reported [ 8 , 9 , 12 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Use of Volar Locking Plate Versus Intramedullary Nailing for Fixation of Distal Radius Fractures: A Retrospective Analysis of Clinical and Radiographic Outcomes

Çalbıyık

İpek

2018

Med Sci Monit

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BackgroundThe objective of this study was to evaluate clinical and radiographic outcomes of volar plate versus intramedullary nailing for fixation of distal radius fractures.Material/MethodsThis retrospective study included 64 patients with extra-articular and simple intra-articular fractures of the distal radius who underwent intramedullary fixation using volar locking plate (n=35, mean age 47.3±16.4 years, 82.9% female) or intramedullary nailing (n=29, mean age 51.3±10.1 years, 58.6% female). Outcome measures were range of motion (ROM); visual analog scale (VAS); Disabilities of the Arm, Shoulder, and Hand (DASH) score; Gartland-Werley score; Stewart score; and radiographic findings.ResultsTime to fracture union was 5.5±1.2 and 5.2±0.6 weeks after volar plate fixation and intramedullary nailing, respectively (p>0.05). Compared to volar plate fixation, intramedullary nailing provided better restoration of volar tilt (6.9±6.3° vs. 9.4±1.6°, p=0.004) and wrist flexion (74.3±15.1° vs. 67.9±13.1°, p=0.003). However, volar plate fixation was significantly better in restoration of supination (85.0±8.3° vs. 81.9±5.1°, p=0.001) and radio-ulnar variance (0.7±0.8 mm vs. 1.1±0.9 mm, p=0.05), DASH score (9.2± 9.0 vs. 15.0 ±3.3, p=0.035), and Gartland-Werley score (1.8±0.9 vs. 4.9±5.4, p=0.004). Volar plate and intramedullary nailing groups were comparable with respect to Stewart score (1.5±0.7 and 1.6±1.3, p>0.05) and complication rates (34.3% vs. 37.9%, p>0.05).ConclusionsBoth volar plate fixation and intramedullary nail fixation provide good clinical and radiographic outcomes for primarily extra-articular or simple intra-articular distal radius fractures. As intramedullary nailing provides better restoration of volar tilt and wrist flexion, volar plate fixation provides better restoration of radio-ulnar variance and wrist supination.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of Volar Locking Plate Versus Intramedullary Nailing for Fixation of Distal Radius Fractures: A Retrospective Analysis of Clinical and Radiographic Outcomes

Çalbıyık

İpek

2018

Med Sci Monit

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“…Distal radius fractures (DRF) are among the most commonly encountered fractures and affect approximately 18% of older adults. [1][2][3][4][5][6][7] Elderly women are at greatest risk of fragility fractures with the decrease in estrogen levels and higher rate of osteoporosis. [7][8][9] Treatment after DRF includes consideration of a patient's lifestyle, co-morbidities, fracture stability, surgeon training and procedural expertise, and hospital setting and resources.…”

Section: Introductionmentioning

confidence: 99%

Pre-injury activity predicts outcomes following distal radius fractures in patients age 60 and older

et al. 2020

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Introduction One out of every 5 elderly patients will suffer a distal radius fracture and these injuries are often related to poor bone health. Several surgical subspecialties have demonstrated that pre-injury activity level can impact patient outcomes. To determine the importance of physical activity, we examined the relationship between pre-injury activity and patient-reported and functional outcomes among fracture patients. Methods This is a retrospective analysis of prospectively collected data from participants enrolled in the Wrist and Radius Injury Surgical Trial (WRIST) from April 10, 2012 to December 31, 2016. This study included 304 adults, 60 years or older with isolated unstable distal radius fractures; 187 were randomized to one of three surgical treatments and 117 opted for casting. Participants opting for surgery were randomized to receive volar locking plate, percutaneous pinning, or external fixation. Participants who chose not to have surgery were treated with casting. All participants were stratified prior to analysis into highly and less-active groups based on pre-injury Rapid Assessment of Physical Activity Scores. Results 280 patients had 12-month assessments of outcomes. Highly active participants scored 8 and 5 points greater on the Michigan Hand Questionnaire at 6 weeks and 3 months respectively, p<0.05. Highly active participants demonstrated greater grip strength at the 3-month (p = 0.017) and 6-month (p = 0.007) time-points. Highly active participants treated with volar

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“…5 Recent evidence suggests that open reduction and internal fixation is becoming the most commonly used for distal radius fracture and re-fractures especially in the elderly. 6 Hospitals with specific Hand Surgery Centers have better outcomes and less complications due to expertise in appropriate equipment placement. 7 This is especially important in rural communities because elderly patients must often travel to one of the larger medical centers to receive care.…”

Section: Introductionmentioning

confidence: 99%

Re-fracture of Distal Radius and Hardware Repair in the Setting of Trauma

Lucke‐Wold

Bonasso

Jacob

2016

Medical Student Research Journal

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Distal radius fractures are one of the most common fractures in the elderly. Falls and motor vehicle collisions lead to increased risk for this type of fracture. A seventy-three year-old female had a previous history of distal radius fracture with repair by open reduction and internal fixation. She was involved in a motor vehicle collision that re-fractured the distal radius. The plate was bent and required removal, which is a very rare but potentially serious complication. Surgery was done to fix the open reduction and internal fixation with volar locking plates while removing damaged hardware. Only a select few cases have reported hardware failure as a cause of complications. Among those cases, high-energy activities and maintained stress on the hardware were likely causes. Distal radius fractures are the most common upper extremity fracture in the elderly. We highlight a unique case of re-fracture in the setting of trauma with prior hardware failure and describe the strategy for hardware repair.

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Volar locking plate fixation for distal radius fractures: Does age affect outcome?

Cited by 6 publications

References 30 publications

Use of Volar Locking Plate Versus Intramedullary Nailing for Fixation of Distal Radius Fractures: A Retrospective Analysis of Clinical and Radiographic Outcomes

Use of Volar Locking Plate Versus Intramedullary Nailing for Fixation of Distal Radius Fractures: A Retrospective Analysis of Clinical and Radiographic Outcomes

Pre-injury activity predicts outcomes following distal radius fractures in patients age 60 and older

Re-fracture of Distal Radius and Hardware Repair in the Setting of Trauma

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