Ergebnisse nach palmarer Plattenosteosynthese mit der winkelstabilen T-Platte bei 100 distalen Radiusfrakturen

Abstract

In a prospective study a total of 124 unstable fractures of the distal radius were treated with a fixed angle palmar T-plate (Synthes Ltd., Switzerland). A total of 100 distal radius fractures were evaluated radiologically and clinically after a mean of 10 months after surgery. Loss of correction between postoperative and follow-up radiographs was assessed. The mean loss of the initial volar tilt was 3+/-4 degrees, the loss of radial inclination 0.4+/-2 degrees. The radial shortening was 1+/-1 mm. Flexion and extension of the injured wrist had recovered to an average of 81% of the normal, contralateral side. Radial and ulnar deviation were limited to 84%, pronation and supination reached 91%. Mass grip strength recovered to an average of 74% of the normal side. Using the functional outcome score according to Sarmiento,we obtained 15% excellent,56% good, 28% fair and 1% poor results. The complication rate was 10%. In conclusion, the operative treatment of unstable extra- and intraarticular fractures of the distal radius by fixed angle T-plateosteosynthesis shows good radiological and functional results.

Functional Outcome Following Fixed-Angle Volar Plating or Intrafocal K-Wire Fixation for Extraarticular Fractures of the Distal Part of the Radius

“…The strategy of using volar plates to fix displaced, extraarticular distal radius fractures has increasingly been found in the last few years' literature [11,19,20,25]. In comparison to dorsally inserted plates, volarly inserted plates have an improved soft-tissue coverage, decreased risk of tendon injury [11], as well as greater mechanical stability [21].…”

“…The introduction of a new plate system enabled a volar plate placement with a fixed-angle [20]. Functional follow-up demonstrated that using this new system, additional dorsal defect filling could be forgone without substantial loss of reduction [25].…”

Palmare winkelstabile Plattenosteosynthese der instabilen distalen Radiusfraktur

“…Auf der Basis winkelstabiler Systeme wurden daher neue Osteosyntheseverfahren entwickelt, die zwar dem Prinzip eines Fixateur interne entsprechen, die erwähnten Komplikationen aber wesentlich einschrän-ken, eine Knochentransplantation kaum noch erfordern und zeitlich nicht, wie ein Fixateur externe, limitiert sind [5,8,[11][12][13].…”

“…Wir mentioned complications, almost always exclude the need for bone grafting and are not limited by a fixed time frame as required by an external fixator [5,8,[11][12][13].…”

Ergebnisse der palmaren winkelstabilen Plattenosteosynthese am distalen Radius

“…Wurden nach einer Umfrage von Schupp et al [9] 2002 noch die Mehrheit der Radiusfrakturen konservativ oder mit Kirschner-Draht-Osteosynthese bzw. Fixateur externe behandelt [4,9], wird heute die palmare winkelstabile Plattenosteosynthese zunehmend als Verfahren der Wahl propagiert [6,7,10]. In der Literatur gibt es bislang keine validen Daten, die die klinisch evidente Über-legenheit dieser Plattensysteme gegenü-ber herkömmlichen Versorgungsstrategien belegen könnten [8].…”