Surgical management of fractures of distal end radius with locking compression plate

Lakshman Prasath Govindarajan, Arun Rajamanickam, Shankar Radhakrishnan

Abstract


Background: Use of fixed angle locking plates with locking screws for fractures of distal radius support the subchondral bone and resist axial forces and an additional benefit is it provides additional strength to fixation by constructing a scaffold under the distal radial articular surface. Aim: To assess the functional outcome of fracture of distal end of radius managed with locking compression plates. Methodology: A prospective longitudinal study was conducted at our hospital for a period of two years. Totally thirty-two patients were included in the study. The fracture fragments were analysed and involvement of radiocarpal and distal radioulnar joints were assessed and classified according to the Frykman’s and AO classification. The appropriate plate is selected following the fracture reduction. Once stable fixation was achieved and hemostasis secured, the wound was closed in layers and sterile compression dressing was applied. All the patients were followed up for a period of 6 months. Results: The outcome evaluation was measured based on demerit score system of Gartland and Werley and for 97% of the patients the results was in the range of good and excellent and for only one patient it was fair and none of the patient had a poor result. Conclusion: Volar approach provides both access with minimal surgical trauma on distal radius and fixation with a better adaptation to surrounding tissues.

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References


Chen Neal C, Jupiter Jesse BMO. Management of distal radial fractures. The J Bone & Joint Surg. 2007; 89- A(9):2051-2062.

Cooney WPIII, Dobyns JH, Linscheid RL. Complications of colles’fractures. J Bone Joint Surg. 1980; 62(4):613-619.

Bradway JK, Amadio PC, Cooney WP III. Open reduction and internal fixation of displaced, Comminuted intraarticular fractures of the distal end of the radius. J Bone Joint Surg. 1989; 71-A(6):839-847.

Musgrave DS, Idler RS. Volar fixation of dorsally displaced distal radius fractures using the 2.4mm locking compression plates. J Hand Surg (Am). 2005; 30 (4): 743-9. DOI:10.1016/j.jhsa. 2005.03.006

Solgaard S, Petersen VS. Epidemiology of distal radius fractures. Acta Orthop Scand, 1985; 56 (5):391-393.

Swiontkowski MF. Increasing rates of forearm fractures in children. JAMA 2003; 290 (24):3193. DOI: 10.1001/jama.290.24.3193-c

Lester GE, Anderson JJ, Tylavsky FA et al. Update on the use of distal radial bone density measurements in prediction of hip and Colles' fracture risk. J Orthop Res. 1990; 8 (2):220-226. DOI:10.1002/jor.1100080210

Chung KC, Watt AJ, Kotsis SV. Treatment of unstable distal radial fractures with the volar locking plating system. J Bone Joint Surg Am. 2006;88 (12): 2687-94. DOI:10.2106/JBJS.E.01298

Arora R, Lutz M, Hennerbichler A, Krappinger D. Complications following internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma. 2007;21(5):316-22. DOI:10.1097/BOT. 0b013e318059b993

Kilic A, Kabukcuoglu Y, Ozkaya U, Gul M, Sokusu S, OzdoganU.Volar locking plate fixation of unstable distal radius fractures. Acta Orthop Traumatol Turc. 2009; 43(4):303-8. DOI:10.3944/AOTT.2010.2275

Osada D, Kamei S, Masuzaki K, Takai M, Kameda M, Tamai K. Prospective study of distal radius fractures treated with a volar locking plate system. J Hand Surg Am. 2008; 33 (5): 691-700. DOI:10.1016/j.jhsa. 2008. 01.024.

Van Eerten PV, Lindeboom R, Oosterkamp AE, Goslings JC. An X-ray template assessment for distal radial fractures. Arch Orthop Trauma Surg. 2008;128 (2): 217-21. doi: 10.1007/s00402-007-0391-y

Gruber G, Zacherl M, Giessauf C, Glehr M, Fuerst F, Liebmann W. Quality of life after volar plate fixation of articular fractures of the distal part of the radius. J Bone Joint Surg Am. 2010;92(5):1170-8. doi: 10.2106 /JBJS.I.00737.

Lozano-Calderón S, Moore M, Liebman M, Jupiter JB. Distal radius osteotomy. In The elderly patient using angular stable implants and norian bone cement. J Hand Surg Am. 2007; 32(7):976-83. DOI:10.1016/j.jhsa. 2007. 05.005

Chung KC, Watt AJ, Kotsis SV. Treatment of unstable distal radial fractures with the volar locking plating system. J Bone Joint Surg Am. 2006;88 (12): 2687-94. DOI:10.2106/JBJS.E.01298

Arora R, Lutz M, Hennerbichler A, Krappinger D. Complications following internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma. 2007;21(5):316-22. DOI:10.1097/BOT. 0b013e318059b993

Kilic A, Kabukcuoglu Y, Ozkaya U, Gul M, Sokusu S, OzdoganU.Volar locking plate fixation of unstable distal radius fractures. Acta Orthop Traumatol Turc. 2009; 43(4):303-8.

Minegishi H, Dohi O, An S, Sato H. Treatment of unstable distal radius fractures with volar locking plate. Ups J Med Sci. 2011; 116 (4):280-4. doi: 10.3109/ 03009734. 2011.594183

Tank G, Gupta AK, Parvez A, Singh G, Jaiswal S, Kumar A. Anatomical and functional evaluation of distal end radius fractures managed by volar plating. Pros study J evol Med dental Sci. 2013;7(2):802.

Fok MWM, Klausmeyer MA, Fernandez DL, Orbay JL, Bergada AL. Volar plate fixation of intra-articular distal radius fractures : A retrospective Study J Wrist Surg. 2013;2(3):247-54. doi: 10.1055/s-0033-1350086

Jakob M, Rikli DA, Regazzoni P. Fractures of distal radius treated by internal fixation and early fuction. J. Bone Joint Surg. 2000;82-B;340-4.

Aggarwal AK, Nagi ON. Open reduction and internal fixation of volar Bartons fractures: A prospective study J ortho sur. 2004;12(2):230-4. DOI: 10.1177/230949900401200218

Mudgal CS, Jupiter JB. Plate fixation of osteoporotic fractures of the distal radius. J. Orthop Trauma. 2008; 22 (8): S106-15. doi: 10. 1097/BOT. 0b013e 31815e9fcd.

Sobky K, Baldini T, Thomas K, Bach J, Williams A, Wolf JM. Biomechanical comparison of different volar fracture fixation plates for distal radius fractures. Hand (N Y). 2008; 3 (2):96-101. doi: 10.1007/s11552-007-9074-y

Drobetz H, Kutscha-Lissberg E. Osteosynthesis of distal radial fractures with a volar locking screw plate system. Int Orthop. 2003; 27 (1):1–6. DOI: 10.1007/s 00264-002-0393-x.

Beharrie AW, Beredjiklian PK, Bozentka DJ. Functional outcomes after open reduction and internal fixation for treatment of displaced distal radius fractures in patients over 60 years of age. J Orthop Trauma. 2004 Nov-Dec;18(10):680-6.

Wong KK, Chan KW, Kwok TK, Mak KH. Volar fixation of dorsally displaced distal radial fracture using locking compression plate. Journal of Orthopaedic Surgery. 2005; l3 (2): l53-157. doi.org/10. 1177/23094 9900501300208

Pattanashetty OB, Shushrut B, Monish b. outcome of fracture distal end of radius in adults treated by open reduction and internal fixation with buttress plate. Kerala Journal of Orthopaedics Issue.2013;26(2):87-92.


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