No significant differences were found between the minimally invasive plate osteosynthesis and conventional plating for distal radius fractures based on the data from postoperative radiologic and clinical outcomes.
BackgroundPlate fixation is one of the standard surgical treatments for distal femoral fractures. There are few reports on the relationship between the screw position and bone union when fixing by the bridging plate (relative stability) method.MethodsThis retrospective study included 71 distal femoral fractures of 70 patients who were treated with the locking compression plate for distal femur (DePuy Synthes Co., Ltd, New Brunswick, CA, USA). The following measurements were evaluated and analyzed: (1) bone union rate, (2) bridge span length (distance between screws across the fracture), (3) plate span ratio (plate length/bone fracture length), (4) number of empty holes (number of screw holes not inserted around the fracture), and (5) medial fracture distance (bone fracture distance on the medial side of the distal femur). Patient demographics (age), comorbidities (smoking, diabetes, chronic steroid use, dialysis), and injury characteristics (AO type, open fracture, infection) were obtained for all participants. Univariate analysis was performed on them.ResultsOf 71 fractures, 26 fractures were simple fractures, 45 fractures were comminuted fractures, and 7 fractures resulted in non-union. Non-union rate was significantly higher in comminuted fractures with bone medial fracture distance exceeding 5 mm.Non-union was founded in simple fractures with bone medial fracture distance exceeding 2 mm, but not significant (p = 0.06). In cases with simple fractures, one non-union case had one empty hole and one non-union case had four empty holes, whereas in cases with comminuted fractures, five non-union cases had two more empty holes.ConclusionsWe concluded that bone fragment distance between fracture fragments is more important than bridge span length of the fracture site and the number of empty holes. Smoking and medial fracture distance are prognostic risk factors of nonunion in distal femoral fractures treated with LCP as bridging plate.
: The purpose of this study was to assess the effect of timing (Early (E) group vs Delayed (D) group) of internal fixation for distal radius fractures on forearm and wrist function in patients who underwent the surgery. The subjects were one hundred six patients who had extra-articular fractures of the dorsally displaced distal radius and were treated with a volar locking plate. The subjects were divided into two groups: E group (Operation on the day of injury or the next day, n = 76 ; and the D group (Operation at 7 days after injury or later, n = 30). Follow-up examinations conducted at 4, 12, and 48 weeks after surgery included measurements of wrist and forearm ranges of motion (ROM), measurement of grip strength (GS), Disability of the Arm, Shoulder and Hand score (DASH), and complications, retrospectively. The patients in both groups improved significantly with respect to ROM, GS, and DASH. At 4 weeks, the patients in the E group had better forearm motion, At 4 and 12 weeks, those who had undergone early surgery had significantly better wrist motion, GS and DASH. At 48 weeks, there were no differences between the groups in ROM, GS, or DASH. Patients with dorsally displaced extra-articular fractures of the distal radius can expect to have better short-term outcomes with early treatment, open reduction and internal fixation using a volar locking plates.
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