Complications of Intramedullary Fixation for Distal Radius Fractures in Elderly Patients: A Retrospective Analysis Using McKay’s Complication Checklist

Wakasugi, Takuma; Shirasaka, Ritsuro; Kawauchi, Toshiyuki; Fujita, Koji; Okawa, Atsushi

doi:10.1142/s2424835518500091

Cited by 2 publications

(2 citation statements)

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“…A significantly higher incidence of implant-related complications may, at least partially account for the lower satisfaction in the plate group. Surgical complications of intramedullary nail fixation may include dorsal superficial radial sensory nerve injury and potentially suboptimal reduction due to inadequate surgical exposure [25]. Higher percentage of transient paresthesia in the nail group should caution the surgeon to aim for a more meticulous soft tissue and to protect the nerve during surgical dissection.…”

Section: Discussionmentioning

confidence: 99%

Intramedullary nailing and plating osteosynthesis in the correction of post-traumatic deformity in late-diagnosed distal radius fractures: a retrospective comparison study

Chen

Cheng

Weng

et al. 2019

BMC Musculoskelet Disord

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Background Various surgical modalities are available for correction of deformity in late-diagnosed distal radius fractures. This study compared surgical outcomes between intramedullary nailing and plating osteosynthesis in open-wedge osteotomy. Methods We retrospectively reviewed 47 unilateral distal radius fractures that underwent open-wedge osteotomy at more than 4 weeks after injury between 2006 and 2011. A locally resected exuberant callus was used as the bone graft. Two types of fixation were used: intramedullary nail in 22 patients (group A) and locking plate in 25 patients (group B). Radiographic analysis including radial height, radial inclination, and volar tilt were performed preoperatively and 2-year postoperatively. The Modified Mayo Wrist Score (MMWS) was used for functional evaluation and a 10-point visual analog scale (VAS) for residual pain assessment. Patient satisfaction was self-reported as a 5-point scale. Radiographic data, functional outcomes, and surgical complications were compared between the two groups. Results All fractures achieved bone union without major complications. The MMWS averaged 84.8 ± 9.7 in group A and 85.2 ± 8.4 in group B, without significant differences ( p = 0.436). Instead, significant differences were found in mean wrist flexion (73.6 ± 7.9 vs. 69.6 ± 7.8 degrees; p = 0.042), patient satisfaction (3.6 ± 1.1 vs. 2.9 ± 1.2; p = 0.034), postoperative radial height (11.6 ± 2.6 vs. 10.2 ± 3 mm; p = 0.039) and inclination (20.8 ± 2.8 vs. 17.7 ± 4.1 degrees; p = 0.004), and implant-related complications (9% vs. 36%; p = 0.03). There were no significant differences in other assessment items including postoperative grip strength, pain scale, supination/pronation/extension, volar tilt, correction angles of all three parameters, and general complication rate. Four patients in group A (18%) and 2 in group B (8%) experienced postoperative paresthesia of the surgical hand; no significant difference was noted. All except one patient in group B had full recovery of neurological symptoms. Conclusions Open-wedge osteotomy with either an intramedullary nail or locking plate fixation yielded encouraging radiographic and functional outcomes. Intramedullary nail fixation may facilitate restoration of radial height and inclination with better wrist flexion, less implant-related complications, and greater patient satisfaction.

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Section: Discussionmentioning

confidence: 99%

Intramedullary nailing and plating osteosynthesis in the correction of post-traumatic deformity in late-diagnosed distal radius fractures: a retrospective comparison study

Chen

Cheng

Weng

et al. 2019

BMC Musculoskelet Disord

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“…According to this study, 1.6% extensor tenosynovitis, 1% extensor tendon rupture, 0.7% flexor tendon rupture, 0.7% flexor tendon tenosynovitis, 0.7% loss of screw fixation, 0.3% lunate facet loss loss, 0.3% distal radioulnar joint injury with screws 0.3% median nerve damage, 0.3% infection complications. One study reported that although intramedullary fixation of the distal radius fractures was less invasive, the patient could not avoid common complications such as trigger finger and carpal tunnel syndrome [26]. Similarly, in another study, it was reported that the results of volar locking plate and intramedullary fixation were similar and both techniques did not reduce postoperative complications [27].…”

Section: Akalın Y Et Al Distal Radius Intraarticular Fracturesmentioning

confidence: 99%

Early and mid-term efficacy of volar titanium lock plate applications in radial distal intraarticular fractures

et al. 2019

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Amaç: Erişkin distal radius kırıklarında titanyum volar kilitli plak uygulanan olgularımıza ait fonksiyonel ve radyolojik sonuçların erken ve orta dönem analizinin yapılarak etkinliğinin ortaya konulmasıdır. Hastalar ve Yöntemler: Distal Radius kırığı nedeniyle volar kilitli plak uygulanan 64 hasta (67 kırık ekstremite) retrospektif olarak incelendi. 36 kadın, 31 erkek, yaş ortalaması 53.31(18-75) idi. Frkyman sınıflamasına göre ve AO sınıflamasına göre sınıflandırıldı. Modifiye Gartlant Werley Skoru, Disabilities of the Arm, Shoulder and Hand (DASH) scoru, Modifiye Stewart skorlama sistemine göre değerlendirildi. Bulgular: Modifiye Gartland-Werley Skoruna göre 35(%52.2)'i mükemmel, 27(%39.7)'si iyi, 4(%5.9)'u orta ve 1'i kötü (%1.5) olarak değerlendirildi. DASH skoru ortalama değeri 9,5±8.8(0-35). Palmar eğim ameliyat öncesi-5.58±14.9 [(-50)-(30)], ameliyat sonrası 3.65±10.88[(-30)-(+45)] olarak değerlendirildi. İstatistiksel olarak radial yükseklik, radial inklinasyon ve palmar eğimin anlamlı düzeyde düzeldiği görüldü(p=0.001). Stewart radyolojik skoru değerlendirildiğinde 37(%54.4)'si mükemmel, 26(%38.8)'i iyi, 4(%5.9)'ü orta olarak değerlendirildi. Sonuç: Erişkin distal radius kırıklarında iyi sonuçların elde edilebilmesi kırığın iyi değerlendirilmesi, uygun tedavi şeklinin seçilmesi, uygun cerrahi tekniğin kullanılması, Anatominin iyi oluşturulması ve sağlam fiksasyon ile mümkün olabilir. Titanyum voler kilitli plak ile kırık tesbiti etkili bir tedavi yöntemi olup erken harekete izin vererek iyileşmeyi hızlandırdığı ve sonuça olumlu katkı sağlamaktadır.

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Complications of Intramedullary Fixation for Distal Radius Fractures in Elderly Patients: A Retrospective Analysis Using McKay’s Complication Checklist

Cited by 2 publications

References 10 publications

Intramedullary nailing and plating osteosynthesis in the correction of post-traumatic deformity in late-diagnosed distal radius fractures: a retrospective comparison study

Intramedullary nailing and plating osteosynthesis in the correction of post-traumatic deformity in late-diagnosed distal radius fractures: a retrospective comparison study

Early and mid-term efficacy of volar titanium lock plate applications in radial distal intraarticular fractures

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