Intramedullary repair device against volar plating in the reconstruction of extra-articular and simple articular distal radius fractures; a randomized pilot study

Zehir, Sinan; Çalbıyık, Murat; Zehi̇r, Regayip; İpek, Deniz

doi:10.1007/s00264-014-2382-2

Cited by 20 publications

(18 citation statements)

References 16 publications

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“…While most authors agreed that intramedullary nails yielded comparable surgical outcomes in acute fractures of the distal radius [23–30], only a few of studies indicated the application of intramedullary nails in malunion [31, 32]. In 2 previous studies, the technique and effectiveness of an intramedullary nail combined with bone graft or graft substitute has been demonstrated for the correction of extra-articular malunions of the distal radius.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies comparing intramedullary nail with a locking plate in the treatment of distal radius fractures are currently available in the literature [28, 30, 34, 35]. All studies concluded that both devices achieved equally good functional outcomes; while a systemic review indicated that intramedullary nails facilitated favorable functional results with radiological and clinical parameters nearly equivalent to locking plates [36].…”

Section: Discussionmentioning

confidence: 99%

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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%

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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“…Among minimally invasive techniques developed for the osteosynthesis of extra-articular fractures of the distal radius, the use of intramedullary nails remains controversial, 11 probably due to complications such as injury to the extensor apparatus by dorsally inserted nails 12 and to the radial nerve branches by laterally inserted nails. 13 With the development of volar locking plates, Henry's extended distal anterior approach or trans-flexor carpi radialis (FCR) approach tends to become the gold standard. 14 It has been used to early mobilize the wrist and limit the number of complications, particularly unwanted calluses and type I complex regional pain syndromes.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Plate Osteosynthesis for Extra-articular Distal Radius Fracture in Postmenopausal Women: Longitudinal versus Transverse Incision

et al. 2018

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Background This work aimed to compare two mini-invasive palmar approaches (longitudinal and transverse) to osteosynthesize fractures of the distal radius. The main hypothesis was that the longitudinal technique gave smaller incisions. The secondary hypothesis was that the longitudinal technique would be better for the recovery of pain, functional scores, strength, and mobility. Materials and Methods The series included 30 extra-articular distal radius fractures in 30 patients (average age: 74 years) fixed with volar locking plate using a mini-invasive technique. Fifteen of these patients had a single longitudinal surgical approach (Group I), and 15 had a transverse approach that was completed with a longitudinal incision for the proximal screws (Group II). Results The combined average incision size was 14.73 mm in Group I and 19.8 mm in Group II. After 6 months, the pain was on average 1.4/10 (Group I) and 0.46/10 (Group II), the quick Disability of the Arm, Shoulder, and Hand was 13.63/100 (Group I) and 2.8/100 (Group II), Patient-Related Wrist Evaluation was 11.8/100 (Group I) and 5.97/100 (Group II), grip strength was 81.06% (Group I) and 72.13% (Group II), flexion was 88.13% (Group I) and 75% (Group II), extension was 86% (Group I) and 64.6% (Group II), ulnar inclination was 89% (Group I) and 78.67% (Group II), radial inclination was 89.73% (Group I) and 79.93% (Group II), pronation was 96.67% (Group I) and 81.46% (Group II), and supination was 91.93% (Group I) and 79.87% (Group II). Clinical Relevance The longitudinal technique gave smaller incisions than the transverse technique. Among the secondary hypotheses, all the variables were better with the longitudinal technique, except the pain, although without any significant difference.

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“… 8 , 9 , 22 , 23 experience and studies on Sonoma Wrx are limited. 24 , 25 In our previous prospective randomized pilot study, we compared standard volar locking plate with intramedullary fixation using the Sonoma Wrx, and found that clinical and radiological outcome of two techniques were comparable and satisfactory in treatment of distal radius fractures. 25 In the current case series, we present our latest experience with Sonoma Wrx in 39 patients with distal radius fractures.…”

Section: Discussionmentioning

confidence: 99%

“…Our radiologic findings indicate over 72% compliance to the radiographic healing criteria defined by Graham.18 VAS, DASH, Gartland-Werley and Stewart scores also indicate excellent clinical, functional, and radiological outcome similar to our previous report. 25 …”

Section: Discussionmentioning

confidence: 99%

Fixation of unstable distal radius fractures by using expandable Intramedullary nailing system in adult patients

Çalbıyık

2018

Pak J Med Sci

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Objective:To present our experience on intramedullary nailing device Sonoma Wrx (Sonoma Orthopedic Products Inc., Santa Rosa, CA, USA) used for internal fixation of extra-articular or simple intra-articular distal radius fractures in adult population.Methods:This study was conducted from February 2011 to October 2016. A total of 48 patients (mean age 47.3±5.6 years, 35.4% females) with distal radius fracture, who underwent intramedullary distal radius fixation by using Sonoma Wrx were included in this retrospective study. Clinical outcome measures (range of motion [ROM], visual analog scale [VAS]), functional outcomes (Disabilities of the Arm, Shoulder and Hand [DASH] score and Gartland-Werley score), radiographic scores (Stewart score) and parameters (radial inclination, volar tilt, radial height, radio-ulnar variance) and complications were evaluated.Results:The total surgery time was 24.3±2.3 minutes. Patients were followed up for 24.7±3.4 weeks. Complete fracture union was obtained at 5.5±0.9 weeks. The postoperative low VAS pain score (1.6±0.93) and high ROM values (76.7° for extension, 78.5° for supination, 80.1° for flexion, and 82.3° for pronation) indicated a very good clinical outcome. DASH score of 8.3±1.5 and Gartland-Werley score of 2.8±4.1 showed good functional outcome. The radiographic Stewart score was 1.0±1.2. Radial inclination, volar tilt, and radial height significantly increased (p<0.001), and radio-ulnar variance decreased (p=0.001) with surgery. No postoperative complication was recorded in 40 patients (83.3%).Conclusions:Sonoma Wrx, which is an expansible intramedullary elastic locking distal radius nail, offers a good alternative technique for internal fixation of unstable distal radius fractures with the advantage of minimum soft-tissue dissection and related postoperative complications.

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Intramedullary repair device against volar plating in the reconstruction of extra-articular and simple articular distal radius fractures; a randomized pilot study

Cited by 20 publications

References 16 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

Minimally Invasive Plate Osteosynthesis for Extra-articular Distal Radius Fracture in Postmenopausal Women: Longitudinal versus Transverse Incision

Fixation of unstable distal radius fractures by using expandable Intramedullary nailing system in adult patients

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