Functional Outcome and Complications at 2.5 Years Following Volar Locking Plate Fixation of Distal Radius Fractures

Macfarlane, Robert J.; Miller, David J.; Wilson, Lynn; Meyer, Carl; Kerin, C.; Ford, David; Cheung, Graham

doi:10.1007/s12593-014-0155-1

Cited by 29 publications

(17 citation statements)

References 35 publications

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“…which compares favorably to several recent series of plate fixation. [26][27][28] Excluding the one outlier with VAS pain score of 8, our VAS pain scores ranged between 0 and 3, indicating a nil-to low-intensity of pain experienced by all patients except one, suggesting the procedure is quite well tolerated. Major complications (reoperation, hardware removal) were documented in four (18.1%) of the patients in this series, only two of which were symptomatic.…”

Section: Discussionmentioning

confidence: 92%

Intramedullary Fixation of Distal Radius Fractures Using CAGE-DR Implant

et al. 2018

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Keywords► Conventus ► distal radius fracture ► internal fixation ► intramedullary fixation ► outcomes AbstractPurpose CAGE-DR implant is a novel Food and Drug Administration approved intramedullary fracture fixation device used for distal radius fractures. We examine a series of 22 patients and report the outcomes with this device. Materials and MethodsA total of 24 patients with distal radius fractures (8 articular AO type C1/C2; 16 extra-articular AO type A2/A3) underwent open reduction and internal fixation (ORIF) using CAGE-DR implant by a single surgeon. Data including fracture type, angle of displacement, radiographic consolidation, grip strength, wrist range of motion (ROM), patient-rated wrist evaluation (PRWE), and Visual Analog Scale (VAS) pain scores were recorded at time of surgery and at standard follow-up. Results All 24 patients underwent uneventful ORIF. At first follow-up visit (9 days), all patients had full digital ROM (measured as 0 cm tip-to-palm distance). Two patients were lost to follow-up. Eighteen of the remaining 22 patients had sufficient radiographic follow-up and all 18 demonstrated healing. At latest follow-up (mean 9.7 months, range, 3-20), VAS pain scores averaged 0.6 (range, 0-8) and PRWE averaged 12.1 (range, 0-53.5). Grip strength of the operated hand averaged 58 lbs (range, 20-130). ROM included: wrist flexion 73°(50-95), wrist extension 78°(60-110), pronation 77°(60-90), supination 79°(60-90), ulnar deviation 31°(5-45), and radial deviation 17°(10-30). Three patients underwent screw removal to prevent tendon irritation. One patient underwent hardware removal due to prominence on imaging but was asymptomatic. There were otherwise no major complications, including complex regional pain syndrome, in the series to date. Conclusion The CAGE-DR fracture fixation system is a promising alternative to established methods of distal radius internal fixation. This series has a low reported pain score starting immediately postoperatively and a low complication rate. This novel device is a promising option for internal fixation of displaced distal radius fractures with a low complication profile. Level of Evidence This is a level IV, therapeutic study.

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Section: Discussionmentioning

confidence: 92%

Intramedullary Fixation of Distal Radius Fractures Using CAGE-DR Implant

et al. 2018

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“…Based on 187 cases with an average follow-up period of 2.5 years, Macfarlane et al found that 8% of complications were caused by metacarpal plate screws, including three cases of tendon injury. This led them to recommended DVR for treatment of unstable distal radius fractures [17]. Two types of locking screws are used in the DVR system, threaded and unthreaded.…”

Section: Discussionmentioning

confidence: 99%

The treatment of complex intra-articular distal radius fractures with turning radius and distal volaris radius plate fixation

Jia¹,

Wang

Jiang³

et al. 2020

Eur J Med Res

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Background Although distal radius fractures (DRFs) are clinically common, intra-articular DRFs accompanied by dorsally displaced free fragments are much less so. At present, it is very difficult to fix and stabilize the intra-articular distal radius fractures accompanying dorsally displaced free fragments with a plate. Our aim was to investigate the clinical effect of DRFs with distally displaced dorsal free mass treated with distal volaris radius (DVR) combined with turning of the radius via the distal palmar approach. Methods From 2015 to 2019, 25 patients with intra-articular distal radius fractures associated with dorsally displaced free fragments were selected and treated with distal volaris radius (DVR) combined with turning of the radius via the distal palmar approach. This study involved 14 males and 11 females, with an average age of 34.5 years (ranging from 21 to 50 years). The mean follow-up period was 16.5 months (ranging from 12 to 22 months). The dorsal displacement of the free fragments was analyzed by X-ray and three-dimensional computed tomography, allowing characterization of postoperative recovery effects by radial height, volar tilt and radial inclination. For the follow-up, we evaluated effects of the surgery by analyzing range of motion (ROM); Modified Mayo Wrist Score (MMWS); and Disabilities of Arm, Shoulder and Hand (DASH) score. Postoperative wound recovery and complications were also monitored to evaluate the clinical therapeutic effects of the surgical procedures. Results X-ray showed that all patients showed reduced fractures, well-healed wounds and recovered function with no obvious complications. Based on the follow-up, patients had a mean radial height of 10.5 mm (ranging from 8.1 to 12.6 mm), mean MMWS of 78.8° (ranging from 61° to 90°), mean DASH score of 16.25 (ranging from 11 to 21), mean ROM for volar flexion of 76.5° (ranging from 62° to 81°), mean ROM for dorsiflexion of 77.1° (ranging from 59 to 83) and mean VAS score of 1.4 (ranging from 1 to 3). Conclusion Treatment of the intra-articular distal radius fractures accompanying dorsally displaced free fragments with turning of the radius and the DVR plate system via the distal palmar approach is effective and has no obvious complications.

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“…Other authors have investigated return to various activities after distal radius fracture. MacFarlane et al 7 found a median return to work time of 5 weeks after volar plating of distal radius fractures, and MacDermid et al 8 showed the mean time lost from work to be 9.2 weeks after sustaining a distal radius fracture. Jones et al 9 showed in a prospective study that 69.5% of patients undergoing volar plating of distal radius fractures would be deemed safe to drive at 18.4 days postoperatively, and an additional 17.4% of patients would be safe to drive at 31.3 days postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Return to Yoga Rates Are High After Volar Plating of Distal Radius Fractures

Goyal

Tsai

et al. 2019

Hand (New York, N,Y.)

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Background: Yoga is a popular activity involving extreme wrist positioning and extension loading. Our purpose was to quantify the prevalence of preoperative yoga participation and characterize subsequent ability to return to yoga in patients undergoing volar locked plating of distal radius fractures. Methods: We retrospectively reviewed all cases of distal radius open reduction internal fixation between August 2015 and March 2017. Patients were included if they were treated with volar locked plating and if they participated in yoga on a regular basis preoperatively. Patients were contacted at a minimum of 1 year postoperatively and surveyed about yoga participation. Results: A total of 149 patients who underwent distal radius volar plating were surveyed. Thirty-one patients (32 procedures, 20.8% of surveyed patients) participated in yoga on a regular basis preoperatively. Overall, 90.3% returned to yoga in some capacity. Mean times to return to yoga in any capacity, with weight-bearing, and in a “steady state” were 5.7, 7.4, and 10.0 months, respectively. Of patients who resumed yoga, 65.5% returned to the same or better level of yoga. Satisfaction with participation in yoga was 8.9 (out of 10). Conclusions: We found a relatively high yoga participation rate in patients undergoing distal radius fracture fixation, suggesting the need to be able to effectively counsel these patients. Our results demonstrate a high rate of return to yoga, although approximately one-third of patients experienced a decreased level of participation. Surgeons can use this information to set appropriate expectations.

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Functional Outcome and Complications at 2.5 Years Following Volar Locking Plate Fixation of Distal Radius Fractures

Cited by 29 publications

References 35 publications

Intramedullary Fixation of Distal Radius Fractures Using CAGE-DR Implant

Intramedullary Fixation of Distal Radius Fractures Using CAGE-DR Implant

The treatment of complex intra-articular distal radius fractures with turning radius and distal volaris radius plate fixation

Return to Yoga Rates Are High After Volar Plating of Distal Radius Fractures

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