Volar Versus Dorsal Fixed-Angle Fixation of Dorsally Unstable Extra-Articular Distal Radius Fractures: A Biomechanic Study

McCall, Todd A.; Conrad, Bryan P.; Badman, Brian L.; Wright, Thomas W.

doi:10.1016/j.jhsa.2007.04.016

Cited by 52 publications

(50 citation statements)

References 26 publications

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“…There is a large volume of literature on clinical performance (functional scores and radiological outcomes) of many modalities, either on their own or in comparison with one or more of others [13]- [19]. This has led to identification and discussion of shortcomings and complications of many modalities [17]. For example, for a VLP system, a) its shortcomings include high possibility for prominence if applied distally and possibility for irritation of tendon(s) [14]; and b) among its complications are carpal tunnel syndrome, peripheral nerve palsy, extensor tenosynovitis, and rupture of tendon(s) [17] [19].…”

Section: Introductionmentioning

confidence: 99%

“…This has led to identification and discussion of shortcomings and complications of many modalities [17]. For example, for a VLP system, a) its shortcomings include high possibility for prominence if applied distally and possibility for irritation of tendon(s) [14]; and b) among its complications are carpal tunnel syndrome, peripheral nerve palsy, extensor tenosynovitis, and rupture of tendon(s) [17] [19]. Thus, there is scope for modifications to current modalities and/or introduction of new ones.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Biomechanical Comparison of Prototype of a Novel Intramedullary Injectable Bioresorbable Polymer-Bioresorbable Balloon Osteosynthesis and a Volar Locking Plate for Treatment of Distal Radius Fractures

Zysk¹,

Lewis²,

Taxier³

et al. 2017

WJET

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Background: There is a large assortment of modalities for the surgical treatment/management of distal radius fractures (DRFs), where the most widely used is the fixed-angle volar plating (VLP) system, which, sometimes, is referred to as the "surgical modality of choice". While outcomes with each modality are usually good to excellent, each has its share of shortcomings and complications. Thus, there is scope for improvements to existing modalities and/or introduction of new ones. Study Purpose: We introduce a novel modality, namely, the prototype of an intramedullary injectable bioresorbable polymer-bioresorbable balloon osteosynthesis (IPBO) system, and investigated its plausibility. Experimental Procedures: The biomechanical performance of a construct comprising a synthetic distal radius (fourth-generation Sawbones ® ) on which a simulated fracture was created (4-mm wide osteotomy positioned 25 mm from the most distal end of the radius) and fixated with a placement of the IPBO system (SIPBO Construct) was compared to that when the fixation was with an approved Ti-6Al-4V alloy VLP system (SVLP Construct), under a clinically-relevant compressive loading protocol. Performance involved determination of quantitative parameters of the construct (initial longitudinal stiffness (ICLS), final longitudinal stiffness (FCLS), and load-to-failure (P f )) and observation and recording of features of the construct at the fracture point. We also determined the quantitative parameters for the intact synthetic distal radius (control). Results: For each of the quantitative parameters, the range of values for SIPBO Construct was within that for SVLP Construct, suggesting that the IPBO System is a plausible modality. Also, for SIPBO Construct, failure occurred within the polymer zone, whereas, for SVLP Con- 310struct, some failure features were fracture of the cortical wall and of the dorsal proximal fragments. Conclusion: The findings suggest that the IPBO system is plausible. As such, it merits further study; for example, determination of the influence of fracture gap fill ratio (defined as the proportion of the fracture gap that is filled by the expanding balloon as the polymer is injected into the balloon) on a large collection of quantitative biomechanical parameters.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Biomechanical Comparison of Prototype of a Novel Intramedullary Injectable Bioresorbable Polymer-Bioresorbable Balloon Osteosynthesis and a Volar Locking Plate for Treatment of Distal Radius Fractures

Zysk¹,

Lewis²,

Taxier³

et al. 2017

WJET

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“…Questa rapida ripresa funzionale dei polsi operati ci sembra quindi il maggiore vantaggio del DNP rispetto alle placche a stabilità angolare, applicate sia volarmente sia dorsalmente, con tecniche più invasive. La stabilità della sintesi con il DNP è confermata anche da un recente studio biomeccanico di confronto con due tipi di placche a stabilità angolare [5]. Si può affermare perciò che il DNP è un valido sistema di fissazione a stabilità angolare per le fratture extra-articolari instabili del radio distale, applicabile con un accesso chirurgico poco invasivo.…”

Section: Risultati E Discussioneunclassified

Il chiodo-placca dorsale DNP: note di tecnica chirurgica

Trevisan

Mantovani

Espen³

et al. 2008

LO SCAL

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Background: There are many methods of treatment for fractures of the wrist and it is true to say that Orthopaedic surgeons are undecided as which method of treatment is best. The particular method of treatment will depend both upon the preference and experience of the surgeon and will also depend upon the nature of the fracture. In particular there are many methods about treatment of extra-articular distal radius fractrures type A2. A3 (Colles fractures). It is also worth saying that traditionally treatment of these fractures has been guided by the statement of Colles in his original paper who said that people with these fractures do well even if the fracture isn't reduced. This has meant that these fractures have tended to be under treated in the past although most Orthopaedic surgeons now realise that treatment of these fractures is important if later problems are to be avoided. This is particularly true these days when patients place greater demands upon their wrists and are less willing to accept limitations of movement and/or pain. Patients and Methods: In this paper, we report our experience with a new plate that has been in use in Europe since April 2005. It is a fixed-amgle intrafocal nail plate. Results: We have treated 25 patients in a period from October 2005 to may 2007. After one year we can only provide provisional results. In all patients we have had a early restart of they common way life without complications though there are, in litterature, cases of rupture of the thumb extensor tendon. Conclusions: the nail plate always has a firm place in our daily routine for those cases where a stable osteosynthes is indicated and in patients that required greater demands upon their wrists and are less willing to accept limitations of movement. IntroduzioneIl trattamento delle fratture del radio distale ha subito un'importante evoluzione dopo l'introduzione delle placche a stabilità angolare, con vantaggio sulla precoce mobilizzazione del polso e delle dita. Questi sistemi di sintesi, però, sono abbastanza invasivi, sia usando un accesso volare sia un accesso dorsale. Per questo è stato ideato da Orbay [1] il chiodo-placca dorsale ("dorsal nail-plate") DNP, che può essere applicato con un piccolo accesso chirurgico dorsale e minore manipolazione dei tendini estensori rispetto alle placche dorsali. Il DNP è un mezzo di sintesi che si può definire misto (chiodo-placca). Esso è costituito infatti da una parte a forma di chiodo che viene inserita intramidollare nel radio prossimale e una parte a forma di placca che viene avvitata con viti o "pin" a stabilità angolare, come una mensola dorsale, sul radio distale fratturato (Fig. 1).

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“…Specimens were loaded in axial compression similar to previously published studies. 12,16,17 We applied a 10 N preload before testing. Axial compression was delivered at 1 N/s over 3 cycles from 20 N to 100 N to determine axial stiffness.…”

Section: Methodsmentioning

confidence: 99%

Biomechanical Properties of Volar Hybrid and Locked Plate Fixation in Distal Radius Fractures

Sokol

Amanatullah

Curtiss

et al. 2011

The Journal of Hand Surgery

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Volar Versus Dorsal Fixed-Angle Fixation of Dorsally Unstable Extra-Articular Distal Radius Fractures: A Biomechanic Study

Cited by 52 publications

References 26 publications

Biomechanical Comparison of Prototype of a Novel Intramedullary Injectable Bioresorbable Polymer-Bioresorbable Balloon Osteosynthesis and a Volar Locking Plate for Treatment of Distal Radius Fractures

Biomechanical Comparison of Prototype of a Novel Intramedullary Injectable Bioresorbable Polymer-Bioresorbable Balloon Osteosynthesis and a Volar Locking Plate for Treatment of Distal Radius Fractures

Il chiodo-placca dorsale DNP: note di tecnica chirurgica

Biomechanical Properties of Volar Hybrid and Locked Plate Fixation in Distal Radius Fractures

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