Most distal radius fractures are currently being treated with anterior plating using anatomical precontoured locking compression plates via the anterior approach. However, it is difficult to fix the volar articular marginal fragment because these anatomical plates should be placed proximally to the watershed line. There were just a few methods of fixation for this fragment on medical literature. Herein, we introduced a tension band wiring technique for fixation of a volar articular marginal fragment in the distal radius.
PURPOSE To evaluate the usefulness of locking compression plate (LCP) and volar plating through anterior approach for distal radius fracture. MATERIALS AND METHODS We retrospectively analysed that 15 distal radius fracture, which would not be reduced by closed reduction or too comminuated to maintain reduction or articular surface inconguency, were treated by open reduction through anterior approach and volar plating using LCP. The results were evaluated by preoperative and postoperative radiographs. Functional results were analysed using the Modified Mayo Wrist Scoring System. RESULTS All cases achieved anatomical articular surface reduction postoperatively. In terms of radiologic analysis, mean radial length (9.0 mm vs. 11.8 mm), radial inclination (14.7degrees vs. 20.9degrees ), volar tilt (-6.3degrees vs. 8.3degrees ) and articular step-off (1.4 mm vs. 0.3 mm) were improved. The average Modified Wrist Score was 89. Nonunion or malunion was not occurred. CONCLUSION Open reduction through anterior approach and volar plating using LCP is a useful method that provides excellent results with few complications in the treatment of fracture of the distal radius.
Citations
Citations to this article as recorded by
Periprosthetic Fracture after Locked Plating in the Osteoporotic Long Bone Fracture Ki-Chul Park, Hong-Sik Kim, Jeong-Han Oh Journal of the Korean Orthopaedic Association.2012; 47(3): 222. CrossRef
2.4 mm Volar Locking Compression Plate for Treatment of Unstable Distal Radius Fractures Sung-Jin Kim, Chul-Hyun Cho Journal of the Korean Fracture Society.2011; 24(2): 151. CrossRef
Treatment of Femur Supracondylar Fracture with Locking Compression Plate Seong Ho Bae, Seung Han Cha, Jeung Tak Suh Journal of the Korean Fracture Society.2010; 23(3): 282. CrossRef
Comparison of Outcomes for Unstable Distal Radius Intraarticular Fractures - T-locking Compression Plate versus External Fixator - Chul-Hyun Cho, Su-Won Jung, Sung-Won Sohn, Chul Hyung Kang, Ki-Cheor Bae, Kyung-Jae Lee Journal of the Korean Fracture Society.2008; 21(1): 51. CrossRef
Basic Principle of the Locking Compression Plate Keun Bae Lee Journal of the Korean Fracture Society.2008; 21(3): 261. CrossRef
Volar T-Locking Compression Plate for Treatment of Unstable Distal Radius Fractures Chul Hyun Cho, Ki Choer Bae, Doo Hyun Kwon Journal of the Korean Fracture Society.2008; 21(3): 220. CrossRef
PURPOSE To analyze the radiologic and clinical results of open reduction and volar plating through anterior approach for distal radius fracture. MATERIALS AND METHODS We retrospectively analysed that 19 distal radius fracture, which would not be reduced by closed reduction or too comminuted to maintain reduction or articular surface incongruency, were treated by open reduction and volar plating through anterior approach. The results were evaluated by preoperative and immediate postoperative radiographics and clinical results were analysed using Green and O'Brien scoring system at final follow up. RESULTS All cases achieved anatomical articular surface reduction postoperatively. In terms of radiologic analysis, mean radial length (8.8 mm +/-4.8 mm vs. 11 mm +/-3 mm), radial inclination (15 degrees+/-5.7 degreesvs. 20degrees+/-5degrees), volar tilt (-11 degrees+/-13 degrees vs. 7 degrees+/-4 degrees) and ulnar plus variant (4 mm+/-3 mm vs. 0 mm+/-1 mm) were improved. The clinical evaluation revealed 9 excellent cases, 7 good cases, 2 fair cases and 1 poor case. The reduction loss and flexor pollicis longus rupture was occurred in one patient, who had severely displaced comminute fracture in initial injury. CONCLUSION Using volar plating, authors gain good radiologic and clinical results. But, additional external fixation is recommended to prevent further collapse in severly comminuted fractures.
Citations
Citations to this article as recorded by
Treatment of Fractures of the Distal Radius Using Variable-Angle Volar Locking Plate Jae-Cheon Sim, Sung-Sik Ha, Ki-Do Hong, Tae-Ho Kim, Min-Chul Sung Journal of the Korean Fracture Society.2015; 28(1): 46. CrossRef