Volar plate versus k-wire fixation of distal radius fractures

Brennan, Stephen; Kiernan, Christine; Beecher, Suzanne M.; O’Reilly, Rory T.; Devitt, Brian M.; Kearns, Stephen; O’Sullivan, Michael E.

doi:10.1016/j.injury.2015.08.040

Cited by 31 publications

(34 citation statements)

References 17 publications

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“…There were eight studies with data beyond 1 year. The mean average follow‐up for each group was sufficiently similar in four . The study by Lee et al .…”

Section: Discussionmentioning

confidence: 72%

“…The use of two parallel centres in two studies addresses some potential for bias. Two studies had serious risk of selection bias as the indication for K‐wire fixation was dictated by surgeon preference . The fidelity of implementation was an issue in two studies as it was the trainee who performed the operation in many cases .…”

Section: Resultsmentioning

confidence: 99%

“…A recent DRF guideline published by the American Academy of Orthopaedic Surgeons (AAOS) provided an ‘inconclusive’ recommendation regarding optimal surgical management . There have been several trials comparing the two fixation methods with variable results regarding functional outcomes, range of motion (ROM), radiological outcomes and complications . Recently published meta‐analyses have identified equivocal results .…”

Section: Introductionmentioning

confidence: 99%

“…10 There have been several trials comparing the two fixation methods with variable results regarding functional outcomes, range of motion (ROM), radiological outcomes and complications. 4,7,8,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Recently published meta-analyses have identified equivocal results. [27][28][29][30][31][32] The selection criteria of this analysis differ from the aforementioned studies by excluding studies of elderly patients exclusively (>65), as well as those with a follow-up period of less than 12 months.…”

Section: Introductionmentioning

confidence: 99%

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Volar locking plating versus percutaneous Kirschner wires for distal radius fractures in an adult population: a meta‐analysis

Youlden

Sundaraj

Smithers

2018

ANZ Journal of Surgery

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Background This paper compares volar locking plates (VLPs) and percutaneous Kirschner wire (K‐wire) fixation for distal radius fractures in an adult population up to and beyond 12 months. The aim of this review is to compare functional and radiological outcomes along with complication rates. A meta‐analysis was performed to investigate this. Methods A systematic review and meta‐analysis was performed using the PRISMA guidelines. A search of major databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and CINAHL) was performed up to November 2017. Prospective and retrospective studies were included. Studies were assessed for quality using the Cochrane Risk of Bias tool. Meta‐analysis was performed using the ‘metafor’ package with R. Results A total of 14 studies (five randomized controlled trials and nine comparative studies) (n = 1535) were identified. Disabilities of the Arm, Shoulder and Hand (DASH) scores were statistically significant for VLP at all follow‐up intervals up to and beyond 12 months. Wrist movements were statistically significant for VLP at 6 weeks. Grip strength was significantly different favouring VLP at 12 months and final follow‐up. VLP provided better restoration of ulnar variance at 6 weeks, but overall radiological outcomes were similar. These results were not clinically significant. K‐wires were associated with an 18% higher risk of complication but the reoperation rate was higher for VLP (4.6% versus 3.2%). Conclusions This study demonstrates similar clinical functional and radiological outcomes for VLP and K‐wire fixation in the short and intermediate term. There is a higher rate of overall complication with K‐wires, but the increased risk of reoperation must be considered when planning surgical fixation of these fractures.

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“…There were eight studies with data beyond 1 year. The mean average follow‐up for each group was sufficiently similar in four . The study by Lee et al .…”

Section: Discussionmentioning

confidence: 72%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Volar locking plating versus percutaneous Kirschner wires for distal radius fractures in an adult population: a meta‐analysis

Youlden

Sundaraj

Smithers

2018

ANZ Journal of Surgery

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“…Majority are treated by volar plating, K-wires or an external fixator. Brennan et al compared volar plating with K-wire fixation where 318 patients were followed up for 32 months, there was no evidence that one had superior functional outcome compared to other (PRWE 17.56 vs. 16.31, p=0.69) [11] . Wilcke et al showed that outcomes between external fixator and volar plating were similar after one year of follow up (PRWE 11 for external fixator vs. 7 for plating) [12] .…”

Section: Discussionmentioning

confidence: 99%

Functional outcome in patients with distal radius fractures treated with fragment specific fixation at tertiary care teaching hospital

Kc¹,

Bansal²

2018

Int. J. Orthop. Sci.

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Introduction: Aim of this study was to study the functional outcome in patients with distal radius fractures treated with ORIF with 2.7mm distal radius plates at 6 months using PRWE score. To study how early the patients can resume activities of their daily living and study various complications related to fragment specific fixation. Methodology: It was a prospective study. All the patients underwent open reduction and internal fixation using fragment specific locking plates based on fracture patterns. Patients were followed up regularly up to 6 months post op. Functional outcomes were analyzed after 6 months of fixation using patient rated wrist evaluation score. Results: In our study 84.38% patients were male (n 27) with average age being 38.59 years. Right side was the dominant wrist seen in 56% patients (n 18). Most common mechanism of injury was to road traffic accidents. Average time from injury to surgery was 7.06 days and average PRWE score by the end of 6 months was 16.53. Excellent outcomes were seen in 71.88% patients (n 23), good in 18.75% (n 6). Superficial infection, secondary collapse and stiffness and numbness were most common complications seen in 2 patients each. 31 patients had fracture union within 3 months and 30 patients returned to pre injury level of activities within 6 months. Conclusion:We conclude from our data that among various fixation methods, fragment specific fixation provides stable and reliable fixation with good functional outcomes as shown by excellent PRWE scores. Keywords: DER, Fragment specific fixation, PRWE score IntroductionFracture of the distal radius continues to be one of the most common skeletal injuries treated by Orthopaedics Surgeons. In fact these injuries account for approximately one sixth of all fractures seen and treated [1] . They constitute 17 % of all fractures and 75% of all forearm fractures [2] . Incidence of intra-articular comminuted Colles' is 23.8 %, chauffeur being 6.3 %, comminuted Smith is 2.5 %, volar barton has incidence of 1.3 %, combined dorsal barton and chauffeur comprises of 1.3 %, dorsal barton accounts for 0.5 % and combined volar barton and chauffeur is rarest at 0.3% [3] . Fractures of the distal radius present a unique set of fixation issues and differ from most other sites. Distal fragments are periarticular and extremely small. The proximity to a tight network of tendons and retinacular sheaths preculedes the use of bulky plates. Distal fragments are too thin to provide adequate thread purchase for bony screws. The mere creation of holes for bone screws in distal fragments can result in iatrogenic comminution. The last decade has witnessed an unprecedented interest in internal fixation techniques: First being columnar fixation with miniature or "fragment-specific" fixation [4] and second fixation of a wide variety of fractures with fixed-angle devices through a single volar approach [5] . Improvements in imaging and recognition of unstable fracture fragments have enabled surgeons to customize their approach and identify an...

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Outcome after treatment of distal radius fractures in the elderly using the IlluminOss® System

Oijen

Vegt

Hagenaars

et al. 2020

Eur J Trauma Emerg Surg

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Purpose Distal radius fractures are very common and account for approximately 17% of all fractures treated. Multiple treatment methods are available to treat these fractures, both operative and nonoperative. This study aimed at evaluating the functional and clinical outcomes after treatment of distal radius fractures with the IlluminOss ® System in adult patients. Methods A retrospective case series was performed in a single-level two-trauma center. All consecutive adult patients with a distal radius fracture, treated with the IlluminOss ® System between 01 August 2012 and 15 August 2015, were included in this study. Baseline patient characteristics and clinical data were retrospectively extracted from the medical records. Radial inclination, volar/dorsal tilt, ulnar variance, and radial length were measured on the latest available standard radiographs. In addition, patients were prospectively subjected to physical examination and were asked to complete the Disabilities of the Arm, Shoulder, and Hand, Patient-Rated Wrist Evaluation, and Short Form-36 questionnaires. Results Twenty-six patients with 31 distal radius fractures were included. The median age at time of trauma was 77 years and 96% were females. Five patients developed a total of seven complications. Due to persisting pain one reoperation was performed, removing a small prominent part of the implant. Both patient-reported outcome scores and radiographic results were good to excellent. Conclusions The IlluminOss ® System is a feasible option to treat distal radius fractures with seemingly good clinical and functional outcome. One out of seven complications required surgical intervention. These outcomes justify more detailed prospective research.

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Volar plate versus k-wire fixation of distal radius fractures

Cited by 31 publications

References 17 publications

Volar locking plating versus percutaneous Kirschner wires for distal radius fractures in an adult population: a meta‐analysis

Volar locking plating versus percutaneous Kirschner wires for distal radius fractures in an adult population: a meta‐analysis

Functional outcome in patients with distal radius fractures treated with fragment specific fixation at tertiary care teaching hospital

Outcome after treatment of distal radius fractures in the elderly using the IlluminOss® System

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