Minimally Invasive Plate Osteosynthesis of Distal Radius Fractures

Vernet, P.; Gouzou, S.

doi:10.1016/b978-0-323-75764-5.00032-9

Cited by 3 publications

(6 citation statements)

References 39 publications

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“…In a literature review, Liverneaux et al, 25 defined several aspects of the MIPO technique based on studies conducted so far: it is indicated for both extra-and intraarticular fractures, it requires a single volar incision shorter than 20 mm, it can be associated with arthroscopic surgery, the radiological and clinical outcomes are similar to those of the conventional technique, and, in cases of difficult reduction, the incision can be easily expanded.…”

Section: Discussionmentioning

confidence: 99%

“…[16][17][18][19] The level of evidence on which the surgeon can rely to choose the MIPO technique over the conventional technique is low. Several authors [20][21][22][23][24][25][26][27] have studied and compared both techniques: some of them show favorable results for the MIPO technique, while others do not find significant differences.…”

Section: Palabras Clavementioning

confidence: 99%

“…[16][17][18][19] El nivel de evidencia en el que el cirujano se pueda apoyar para elegir la técnica MIPO frente a la técnica convencional es bajo. Varios autores [20][21][22][23][24][25][26][27] han estudiado y comparado ambas técnicas: algunos de ellos muestran resultados favorables para la técnica MIPO; en cambio, otros no encuentran diferencias significativas.…”

Section: Introducción Y Objetivounclassified

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Placa volar bloqueada en fracturas de radio distal: Técnica mínimamente invasiva versus técnica convencional

Ruiz Villanueva,

Salvat Dávila

et al. 2024

Revista Iberoamericana de Cirugía de la Mano

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Resumen Introducción En los últimos años, la cirugía ha ganado relevancia en el tratamiento de las fracturas del extremo distal del radio (FEDR). Dentro de las técnicas quirúrgicas, la osteosíntesis con placa mínimamente invasiva (minimally-invasive plate osteosynthesis, MIPO, en inglés) está en auge, y se han incrementado sus indicaciones respecto a la técnica convencional. Materiales y Métodos Estudio retrospectivo que incluyó 81 pacientes intervenidos de FEDR durante el año 2021 en nuestro centro hospitalario, correspondientes a fracturas de los tipos I, II y III de la clasificación de Fernández. Se compararon resultados radiológicos, clínicos y funcionales, y la aparición de complicaciones al finalizar el seguimiento a los 6 meses. Resultados El grupo MIPO estuvo formado por 21 pacientes (8 hombres y 13 mujeres) con una edad media de 57,3 años, y el grupo convencional, por 60 pacientes (11 hombres y 49 mujeres) con una edad media de 60,8 años. La Escala Radiológica de Castaing mostró un resultado global favorable para la técnica MIPO frente a la técnica convencional (p = 0,049), y se obtuvieron diferencias a favor del grupo MIPO en la inclinación sagital/volar (10,5 vs. 7,3°; p = 0,0006). La Escala Visual Analógica (EVA) ofreció un resultado de 1,5 para la técnica MIPO, y de 2,9 para la técnica convencional (p = 0,0141). La puntuación en la versión corta del cuestionario de Discapacidades de Brazo, Hombro y Mano (Quick Disabilities of the Arm, Shoulder and Hand, QuickDASH, en inglés) fue ligeramente superior para el grupo MIPO (13,5%) respecto al grupo convencional (19,6%), pero no tuvo significación estadística. Se reportaron resultados similares para el rango de movimiento (RDM), excepto en la pronación y la fuerza de prensión, que fueron favorables para el grupo MIPO. Las complicaciones, como lesión nerviosa, dolor crónico, lesión tendinosa y secuelas estéticas, fueron mayores en porcentaje con la técnica convencional. Conclusión Para el tratamiento de las FEDR, la técnica MIPO, empleando placa extracorta mediante un abordaje biológico, puede lograr resultados funcionales al menos tan buenos como los de la técnica convencional, con mejores resultados radiológicos, menor dolor posoperatorio, menor tasa de complicaciones y mejores resultados estéticos.

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Section: Discussionmentioning

confidence: 99%

Section: Palabras Clavementioning

confidence: 99%

Section: Introducción Y Objetivounclassified

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Placa volar bloqueada en fracturas de radio distal: Técnica mínimamente invasiva versus técnica convencional

Ruiz Villanueva,

Salvat Dávila

et al. 2024

Revista Iberoamericana de Cirugía de la Mano

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“…The BR splitting approach for sparing PQ muscle had advantages over the latter approach in exposing the fracture surface. Adequate intraoperative fracture exposure could greatly avoid a series of complications [14,27].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the treatment of distal radial volar fracture by different methods sparing the pronator quadratus

Huang¹,

Liu²,

Xue

et al. 2023

Preprint

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Background The conventional volar approach requires the release of the pronator quadratus (PQ) muscle in the treatment of distal radius fractures. However, releasing PQ muscle could cause loss of function and a host of complications.Aim This study compared the outcomes of different methods of sparing the PQ muscle combined with volar plate in the treatment of distal radius fractures.Methods A total of 68 patients with distal radius fractures were enrolled with either the brachioradialis (BR) splitting approach (Group A,33 people) or through the tunnel behind the PQ muscle approach (Group B,35 people). Postoperative internal fixation, fracture healing and postoperative complications were observed in the two groups. The visual analog scale (VAS) of postoperative wrist pain was compared between the two groups. The Dienst joint scale was used to evaluate the wrist function of patients, and imaging indexes were used to evaluate the surgical efficacy.Results A total of 68 patients with distal radius fractures were followed up for more than 1 year after surgery. All fractures obtained good union, with no vascular injury, nerve injury, or wound infection. There was no significant difference in the baseline characteristics of both groups. Outcomes at 3 days,1 month,and 3 months all showed no significant differences in postoperative imaging indexes between the two groups. There were significant differences in the mean operative time between the two groups. Nevertheless, no significant differences were shown in mean operative blood loss and mean bone union time between the two groups. There was no significant difference in the results of complications between the two groups. No significant differences in limb function scores, VAS scores and the mean range of motion existed the two groups at the 12-month postoperative follow-up. However, outcomes assessed at 1 week, 1 month, and 3 months after surgery demonstrated significant differences in the VAS scores and the mean range of motion between the two groups.Conclusion Our results demonstrated that these two different surgical approaches were effective ways to reserve PQ and had good clinical outcomes. Placing the plate under the quadratus muscle could reduce early postoperative pain, promote early activity, and returned to normal life. The BR splitting approach was more advantageous in intraoperative fracture exposure and could shorten the operative time. However, some defects also existed. Therefore, surgeons should be aware of their individual characteristics and chose patients carefully.

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“…Percutaneous approaches obtain better aesthetic results and similar functional results with respect to conventional approaches, and they reduce associated soft tissue damage. 27 Preservation of pronator quadratus avoids loss of pronator strength, protects flexor tendons, improves blood supply to articular fragments, and provides distal radioulnar stability. 28 Regarding the suture fixation techniques, some studies mention the lasso suture, used to maintain the reduction of dorsal fragments hardly accessible from volar.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Fixation with Dorsal Suspension Button and Volar Plate in Distal Radius Fractures with Dorsal Die Punch Fragments: A Preliminary Study

Miró¹,

Bensi²,

Rodríguez³

et al. 2022

J Wrist Surg

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Objective The objective of the study is to analyze the clinical and radiological results obtained using a minimally invasive fixation technique with a volar locking plate and a suspension system with a dorsal button in distal articular radius fractures with dorsal comminution. Materials and Methods Six patients with distal radius fractures, between 19 and 68 years of age, were included in the study. Mean follow-up was of 15 weeks. Range of motion (ROM) in flexion, extension, radial deviation, ulnar deviation, pronation, supination, the strength in kilograms, and values on the Visual Analog Scale (VAS), Disabilities of Arm, Shoulder and Hand (DASH), and Mayo Wrist Score (MWS) scales were evaluated at 4, 8, and 12 weeks postoperative. Correction of anteroposterior diameter of the radius and concordance between postoperative anteroposterior diameter and the contralateral wrist diameter were evaluated radiologically. Results The following mean values were obtained at 12 weeks postoperative: ROM in flexion: 40.5°, ROM in extension: 49.5°, ROM in radial deviation: 24.5°, ROM in ulnar deviation: 15°, ROM in pronation: 87°, ROM in supination: 89°, strength: 37.5 kg, pain in VAS scale: 2 points, DASH: 54.5 points, and MWS: 67.5 points. At 12 weeks postoperative, the mean correction of anteroposterior diameter was 0.49 mm. The anteroposterior diameter and that of the contralateral wrist were strongly correlated. Conclusion Fixation with the volar locking plate and dorsal suspension button could be considered an alternative to dorsal plate fixation for treatment of distal radius fractures with comminution or associated dorsal die punch fragments.

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Minimally Invasive Plate Osteosynthesis of Distal Radius Fractures

Cited by 3 publications

References 39 publications

Placa volar bloqueada en fracturas de radio distal: Técnica mínimamente invasiva versus técnica convencional

Placa volar bloqueada en fracturas de radio distal: Técnica mínimamente invasiva versus técnica convencional

Evaluation of the treatment of distal radial volar fracture by different methods sparing the pronator quadratus

Minimally Invasive Fixation with Dorsal Suspension Button and Volar Plate in Distal Radius Fractures with Dorsal Die Punch Fragments: A Preliminary Study

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