Hairline fractures following volar plating of the distal radius: a recently recognized hardware-related complication

Otremski, Hila; Dolkart, Oleg; Atlan, Franck; Hutt, Dan; Segev, Elad; Pritsch, Tamir; Rosenblatt, Yishai

doi:10.1007/s00256-018-2877-9

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…One case of periprosthetic fracture occurred in our sample. There is some evidence that periprosthetic fractures around the screw line may increase with the use of the stiff second-generation hexalobe screws which can be used in the fixation of Acu-Loc plates [ 24 ]. In our center, the second-generation hexalobe screws are not routinely used.…”

Section: Discussionmentioning

confidence: 99%

Low Rates of Hardware Removal and Tendon Rupture for the Acu-Loc 2 Volar Distal Radius Plate: A Minimum One-Year Follow-Up Study

Bharadwaj,

Yogarajah,

Wignadasan

et al. 2024

Cureus

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Aim: Volar locking plates designed for far distal radius fracture fixation can have a significant hardware removal rate and risk of tendon rupture. Plate design has a role in the rate of complications. This study assessed the hardware removal and tendon rupture rate of the Acu-Loc 2 volar distal radius (VDR) plate often used in the treatment of far distal radial fractures. Method: We searched our electronic healthcare records system for all patients who had undergone fixation with an Acu-Loc 2 VDR plate (Acumed, Hillsboro, OR, USA) at a tertiary center between January 2017 and December 2021. Patients were excluded if their follow-up time was less than one year or if they could not be contacted by telephone follow-up. Pre-operative radiographs were examined for fracture classification. Follow-up time was defined as the last contact in the clinic or by telephone. Results: A total of 92 patients underwent an open reduction and internal fixation (ORIF) with an Acu-Loc 2 VDR plate. A total of 85 patients met the inclusion criteria for this study. Our cohort included 33 males (38.8%) and 52 females (61.2%). The mean age was 50 years. Twenty-seven fractures (31.0%) were extra-articular, and 60 fractures (69.0%) were intra-articular. The mean follow-up time for the patients was 593.3 days (range 369 to 1185 days). Four patients (4.7%) had their hardware removed. Three (3.5%) patients underwent removal due to tendon irritation and one patient (1.2%) due to a peri-prosthetic fracture around the plate. There were no tendon ruptures recorded. Conclusion: The Acu-Loc 2 VDR plate had a low medium-term hardware removal rate and no tendon ruptures. These rates are lower than would be expected when compared with other far distal plate designs.

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Section: Discussionmentioning

confidence: 99%

Low Rates of Hardware Removal and Tendon Rupture for the Acu-Loc 2 Volar Distal Radius Plate: A Minimum One-Year Follow-Up Study

Bharadwaj,

Yogarajah,

Wignadasan

et al. 2024

Cureus

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Wrist Fractures and Osteoporosis

Strickland

Chambers

2019

Orthopedic Clinics of North America

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Effect of Downsized Screw Selection on Bone Healing and Postoperative Complications in Volar Plating of Distal Radius Fractures

Ohno¹,

Takigawa²,

Watanabe³

et al. 2021

Orthopedics

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When performing volar plating of distal radius fractures, selecting downsized subchondral screws may prevent dorsal screw penetration (DSP), which is a risk factor for extensor tendon rupture. However, downsizing may cause loss of reduction or poor bone healing. This prospective study investigated the effect of downsized screw selection on bone healing and postoperative complications. A total of 115 patients with postoperative follow-up longer than 6 months comprised the study population. Using a depth gauge, screws that were 2-mm shorter than the measured value were selected. The DSP then was checked using dorsal tangential view (DTV) radiographs during surgery and at final follow-up. Baseline data included bone healing, loss of reduction of radiological parameters, DSP location, and postoperative complications. To assess DSP on DTV radiographs, the dorsal surface of the radius was divided into the radial and ulnar sides at the Lister tubercle, and each was further divided into 2 equal regions. These 4 regions were defined as zones 1 to 4 from the radial side. A total of 114 patients (99%) showed bone healing. Mean loss of reduction was approximately 1° and within 1 mm in radiological parameters. Eleven patients (9.6%) showed DSP during surgery or at final follow-up despite using 2-mm downsized screws. The most common site of DSP was zone 3. Extensor pollicis longus rupture occurred in 2 patients (1.7%) despite no DSP. Downsized screw selection provided a high rate of bone healing with minimum loss of reduction and a low complication rate. The extensor tendon can be torn regardless of DSP. [ Orthopedics . 2021;44(2):e259–e265.]

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Hairline fractures following volar plating of the distal radius: a recently recognized hardware-related complication

Cited by 3 publications

References 11 publications

Low Rates of Hardware Removal and Tendon Rupture for the Acu-Loc 2 Volar Distal Radius Plate: A Minimum One-Year Follow-Up Study

Low Rates of Hardware Removal and Tendon Rupture for the Acu-Loc 2 Volar Distal Radius Plate: A Minimum One-Year Follow-Up Study

Wrist Fractures and Osteoporosis

Effect of Downsized Screw Selection on Bone Healing and Postoperative Complications in Volar Plating of Distal Radius Fractures

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