Volar locking plate fixation of distal radius fractures: Isokinetic assessment of the influence of an ulnar styloid process fracture on pronation-supination strength

Daumillare, Alexandre; Bosch, C.; Julia, M.; Coulet, Bertrand; Marès, Olivier; Chammas, Michel

doi:10.1016/j.hansur.2019.09.011

Cited by 6 publications

(4 citation statements)

References 29 publications

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“…A fracture of the styloid process of the ulna is a common injury related to the fracture of the distal radius. 53% of the distal radius fractures are accompanied by ulnar styloid process fractures, and 26% of them often have nonunion [ 29 ]. There has been a long debate about whether the fracture of the styloid process of the ulna has an impact on the healing of the fracture of the distal radius.…”

Section: Discussionmentioning

confidence: 99%

Clinical Features and Surgical Strategies of Distal Radius Posttraumatic Deformity

Zhang

Fang

2022

Emergency Medicine International

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Objective. To investigate the clinical features and surgical strategies of distal radius posttraumatic deformity. Methods. A retrospective analysis was performed on the data of 30 patients with distal radius posttraumatic deformity treated by osteotomy and orthopedic surgery in the department of orthopedics, the First Affiliated Hospital of Nanjing Medical University, from February 2016 to November 2018. All the patients underwent preoperative anterior and lateral X-ray plain scanning of bilateral wrist joints, showing different degrees of radius shortening, inferior ulnar and radial mismatch, palmar angle, and ulnar deviation angle, among which 11 patients had an uneven joint surface. After a full evaluation, osteotomy and orthopedic surgery were performed to restore the original anatomical structure, plaster fixation was performed for two weeks after surgery, and regular outpatient follow-up was conducted. The function of the wrist was evaluated by the MMWS (wrist joint improvement) scoring scale before and after surgery, and the changes in the wrist joint-related treatment parameters were evaluated according to X-ray. Results. All 30 patients had no neurological symptoms after surgery, and all wounds healed within the first stage. All patients were followed up for 6–12 months, with an average healing time of 3.5 months. There was no reduction loss, internal fixation loosening, or fracture in the regular postoperative review. Postoperative MMWS (wrist joint improvement) score scale data were significantly higher than those before surgery, and there were differences between groups ( P < 0.05 ). Postoperative treatment parameters of wrist joints such as palmar inclination angle, ulnar deviation angle, radius height, and lower ulnar and radial matching were significantly improved, and there were differences between groups ( P < 0.05 ). Conclusions. The patients with distal radius posttraumatic deformity have the clinical characteristics of shortening of radius, mismatch of lower ulnar and radius, an abnormal inclination of palm, and ulnar declination. For patients with distal radius posttraumatic deformity, osteotomy and orthopedic surgery can effectively improve wrist function and improve patients’ quality of life, which is worthy of clinical reference.

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Section: Discussionmentioning

confidence: 99%

Clinical Features and Surgical Strategies of Distal Radius Posttraumatic Deformity

Zhang

Fang

2022

Emergency Medicine International

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“…[ 24 – 26 ] Although it has been reported that some forearm rotation was affected,[ 27 ] isokinetic evaluation was not performed in the comparative trials evaluating distal radial fractures. Daumillare et al[ 9 ] investigated the impact of an ulnar styloid process fracture on pronation and supination strength in isometric and isokinetic tests. They compared the ratio between the operated and contralateral sides for each patient and they reported that a decrease in pronation-supination strength in patients with ulnar styloid process fractures.…”

Section: Discussionmentioning

confidence: 99%

“…They reported that, the isokinetic test can give objective data on strength recovery and could help the surgeon’s clinical evaluation to assess the functional recovery of the operated shoulder over time. Daumillare et al[ 9 ] ınvestigated the impact of a ulnar styloid process fracture on pronation and supination strength in isometric and isokinetic tests. Recent prospective randomized trials have reported rapid functional recovery after volar plate fixation compared with EF, but no functional advantages were demonstrated at 2 years.…”

Section: Introductionmentioning

confidence: 99%

Volar-locking plate versus external fixator in the management of distal radius fractures: an isokinetic study

Dündar¹

2021

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: The aim of this study was to compare the clinical and isokinetic evaluation of distal radius fractures treated by volar locking plate (VLP) and external fixator. METHODS: The study included fifty patients with distal radius fracture type C1/C2/C3. Twenty-seven patients (12 men, 15 women; mean age 49.5±4.42) underwent open reduction and VLP fixation, and 23 patients (10 men, 13 women; 52.1±4.6) underwent closed reduction and external fixation. The follow-up period was at least 12 months and the mean following time was 13.5±1.02 (12–15) months. The functional parameters measured were range of motion (ROM) and grip strength. Radiographic parameters (radial inclination, palmar tilt, and radial height) and isokinetic evaluation were measured at the 6 months and at the final follow-up after surgery. The isokinetic test was done at the speed of 60º/s. The non-fractured arm was tested first and all results were also expressed as a percentage of that on the normal side. Wrist scores according to the disability of the arm, shoulder, and hand (DASH) questionnaire were used. RESULTS: The DASH scores, grip strength, and palmar flexion were better in VLP group at the 6 months (p<0.05). However, there were no differences between two groups at the one year (p=0.79). Isokinetıc evaluation of the VLP showed that peak pronatıon torque and total pronation work were better than external fıxatıon at the 6 month (p<0.05). At the final of follow-up was seen no significant differences between two groups (p=0.11). CONCLUSION: We looked at external fixation and locked volar plates in a prospective study and we found an improved range of movement and isokinetic evaluation outcome at 6 months after locked plating, but there were no differences between two groups at the final of follow-up. Our study showed no evidence for the superiority of one treatment over the other at the final follow-up.

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“…Some studies have reported that the pronation-supination force decreases in patients with USF. 27,28 Relatively decreased wrist ROM, grip strength, and rotational forces may have led to poor results in dexterity tests in DRF patients with USF.…”

Section: Discussionmentioning

confidence: 99%

Ulnar Styloid Fracture Accompanying Distal Radius Fracture Does Not Affect Hand Function, but What About Hand Dexterity?

Usta

Eraslan

Sarıipek

et al. 2021

Journal of Hand and Microsurgery

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Introduction Hand dexterity is not addressed in patients with distal radius fracture (DRF) accompanied with ulnar styloid fracture (USF) in literature. This study aimed to determine whether an associated USF following a DRF has any effect on hand dexterity. Materials and Methods Patients diagnosed with DRF were included in the study and were divided into two groups according to the USF presence (USF group and non-USF group). Pain, range of motion, Quick-DASH (Quick-Disabilities of the Arm, Shoulder, and Hand), handgrip and pinch strength, Purdue Pegboard test, and Jebsen Taylor Hand Function test were measured in the sixth month. Results A total of 125 patients, 68 females (54.4%) and 57 males (45.6%) were included in the study. The mean age of the patients was 47.15 ± 13.41 (18–65) years. There were 60 patients (48%) in the USF group and 65 patients (52%) in the non-USF group. No significant difference was found in pain, range of motion, Quick-DASH and handgrip and pinch strength between the groups (p > 0.05). The hand dexterity tests showed no statistically significant difference between the groups in the sixth month (p > 0.05). Discussion Hand function can be determined more accurately by assessing hand dexterity. In this study, it is emphasized that concomitant USF does not lead to poorer hand dexterity.

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Volar locking plate fixation of distal radius fractures: Isokinetic assessment of the influence of an ulnar styloid process fracture on pronation-supination strength

Cited by 6 publications

References 29 publications

Clinical Features and Surgical Strategies of Distal Radius Posttraumatic Deformity

Clinical Features and Surgical Strategies of Distal Radius Posttraumatic Deformity

Volar-locking plate versus external fixator in the management of distal radius fractures: an isokinetic study

Ulnar Styloid Fracture Accompanying Distal Radius Fracture Does Not Affect Hand Function, but What About Hand Dexterity?

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