Open reduction and internal fixation of distal radial fractures using the Pi-plate

Fawzy, Ernest; Kateros, Konstantinos; Papagelopoulos, Panayiotis J.; Themistocleous, George S.; Chennangiri, Ramesh J.; Gillham, Nicholas R.

doi:10.1016/j.injury.2004.06.007

Cited by 5 publications

(3 citation statements)

References 17 publications

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“…These findings are better compared with the findings in other studies on combined plating. 14,15,24,25 Landgren et al reported a wrist flexion of 65 degrees and extension of 63 degrees in a randomized controlled study in a group of AO type A and C fractures treated with fragment-specific fixation with similar results for another group treated with volar locking plates which is better than the flexion and extension in this study. 26 This could indicate that wrist extension may be negatively affected by the dorsal exposure in combined plating, compared with the more limited dorsal approach in fragment-specific fixation.…”

Section: Discussionsupporting

confidence: 73%

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Combined Plating of Intra-Articular Distal Radius Fractures, a Consecutive Series of 74 Cases

2020

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Background: The distal radius fracture (DRF) is the most common fracture in adults. For unstable intra-articular fractures, the choice of treatment is often operative. The optimal choice of fixation remains a matter of discussion. Question/Purpose: Can combined volar and dorsal plating, using a dorsal frame plate, achieve a good functional and radiographic 1-year outcome in intra-articular DRFs? Methods: In a retrospective cohort study, we evaluated 74 consecutive patients operated with combined plating using a volar plate and a dorsal frame plate. The DRFs were operated between 2016 and 2017 and all cases were AO type C intra-articular fractures. The primary outcome was patient-reported outcome measures including radiographic examination 1 year postoperatively. Secondary outcome measures included wrist range of motion, visual analog scale (VAS) pain scores, and hand grip strength. Results: The median patient-rated wrist evaluation score was 18 points; the quick disabilities of the arm, shoulder, and hand score was 14.8 points. The median Batra radiographic score was 88. Wrist extension was 76% of the uninjured side, flexion was 74%, pronation was 94%, and supination was 94%. VAS pain scores were 0 at rest and 2 during activity. Hand grip strength was 82% compared with the uninjured side. The radiographic outcome according to Batra did not correspond to the patient-reported outcome. Patients older than 60 years had significantly better QuickDASH (quick disabilities of the arm, shoulder, and hand) and PRWE scores (patient-rated wrist evaluation scores) and less pain during activity compared with younger patients despite similar radiographic outcome. There were no tendon ruptures; hardware removal was performed in 21 of the 74 patients. Conclusion: The radiographic outcome did not correspond to the functional outcome 1 year postoperatively. Older patients report less pain and better functional outcome compared with younger patients. There were no tendon ruptures and the frequency of hardware removal was acceptable. Complex intra-articular DRFs AO type C can be managed with volar and dorsal frame-plate fixation to restore distal radius anatomy and achieve a good functional outcome.

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Section: Discussionsupporting

confidence: 73%

“…Combined plating using the pi-plate has previously demonstrated a good outcome in the treatment of complex DRFs. 14,15,23,24 However, the pi-plate has been discontinued by the manufacturer. The dorsal frame plate is a modern plate with a smooth low-profile surface sharing some similarities with the pi-plate.…”

Section: Discussionmentioning

confidence: 99%

Combined Plating of Intra-Articular Distal Radius Fractures, a Consecutive Series of 74 Cases

2020

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“…5,[8][9][10] Although dorsal fixation is a relatively stable construct that allows early motion, concerns have been raised due to demanding requisite surgical dissection, which involves resection of Lister's tubercle, and outcomes that may be compromised with tendonitis/tenosynovitis or rupture of extensor tendons. 4,[11][12][13][14][15][16][17][18][19][20][21][22][23][24] Routine removal of dorsally placed hardware has been recommended by some authors. 15,25 Volar locking plates have been designed to avoid extensor tendon complications observed with dorsal plates while still delivering stable fixation that allows for early motion in comminuted and dorsally angulated distal radius fractures.…”

Section: Introductionmentioning

confidence: 99%

Does a Volar Locking Plate Provide Equivalent Stability as a Dorsal Nonlocking Plate in a Dorsally Comminuted Distal Radius Fracture?

Kandemir¹,

Matityahu²,

Desai³

et al. 2008

Journal of Orthopaedic Trauma

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This study suggests that the fixation obtained with volar locking plates is as stable as fixation with a dorsal plate in acute healing period and can withstand the functional demands of the immediate postoperative period in dorsally comminuted unstable extra-articular distal radius fractures. Elimination of dorsal tendinopathy by using volar locking plates may lead to fewer long-term complications. Locking plates provided better stability in specimens with osteoporosis.

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Hand Numbness and Carpal Tunnel Syndrome after Volar Plating of Distal Radius Fracture

Koo

et al. 2010

Hand (New York, N,Y.)

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We report the incidence of late onset post-operative carpal tunnel syndrome (late carpal tunnel syndrome) and late median nerve neuropathy after volar plating of distal radius fracture by conducting a retrospective study on volar plating for distal radius fracture performed during 2002 to 2006. Two hundred eighty-two volar plating were performed for acute distal radius fracture after exclusion. Post-operative hand numbness occurred in 24 patients of which nine had carpal tunnel syndrome. Thus, the incidence of late carpal tunnel syndrome was 3.2% (9/282). Of the eight (8/24, 33%) patients with post-operative hand numbness that failed to respond to conservative treatment, five had carpal tunnel release and three had neurolysis of median nerve at distal forearm. All had clinical improvement except in one patient. The incidence of late carpal tunnel syndrome after volar plating of distal radius in the present series is similar to the prevalence of carpal tunnel syndrome in general population. The incidence is low compared with other series, regardless of treatment method (conservative treatment, volar or dorsal plating). The outcome of post-operative hand numbness is generally favourable.

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Open reduction and internal fixation of distal radial fractures using the Pi-plate

Cited by 5 publications

References 17 publications

Combined Plating of Intra-Articular Distal Radius Fractures, a Consecutive Series of 74 Cases

Combined Plating of Intra-Articular Distal Radius Fractures, a Consecutive Series of 74 Cases

Does a Volar Locking Plate Provide Equivalent Stability as a Dorsal Nonlocking Plate in a Dorsally Comminuted Distal Radius Fracture?

Hand Numbness and Carpal Tunnel Syndrome after Volar Plating of Distal Radius Fracture

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