Outcomes After Volar Plate Fixation of Low-grade Open and Closed Distal Radius Fractures Are Similar

Kim, Jae Kwang; Park, Sang Doo

doi:10.1007/s11999-013-2798-9

Cited by 20 publications

(10 citation statements)

References 21 publications

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“…Currently, most authors select surgical treatment for displacement of more than 1~2 mm for intra-articular fractures of the distal radius [15–21]. Therefore, we regarded displaced ICF as unstable fracture for which surgical treatment was indicated, and non-obvious displaced ICF as stable fracture for which conservative treatment was indicated.…”

Section: Discussionmentioning

confidence: 99%

“…Another main purpose of any classification system is to assist in clinical decision-making with respect to the need for operative versus non-operative care, the surgical approach, the reduction-fixation method, and outcome prediction. Currently, most authors select surgical treatment for displacement of more than 1~2 mm for intra-articular fractures of the distal radius [ 15 – 21 ]. Therefore, we regarded displaced ICF as unstable fracture for which surgical treatment was indicated, and non-obvious displaced ICF as stable fracture for which conservative treatment was indicated.…”

Section: Discussionmentioning

confidence: 99%

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A new classification and its value evaluation for intermediate column fractures of the distal radius

Yang¹,

Yin²,

Li³

et al. 2018

J Orthop Surg Res

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BackgroundIntermediate column fractures of the distal radius (ICF) are fractures only or mainly limited to the lunate fossa of the distal radius. There are no classification systems and its value evaluation for ICF in the literature.MethodsAccording to the characteristics of ICF, ICF were divided into the volar, dorsal, split, collapse, and collapse with split types. Inter- and intra-observer agreements were analyzed with kappa statistics. Seventy-four patients with ICF were retrospectively studied from January 2008 to June 2016. Surgical approach and reduction-fixation method were taken under the guidelines of the classification in 54 patients with displaced fractures, while conservative treatment was taken in 16 patients with non-obvious displaced fractures and 4 patients with displaced fractures who declined surgery.ResultsThe inter- and intra-observer kappa coefficients were 0.875~0.925 and 0.900~0.950, respectively. All patients were followed up for 13~36 months (average, 18.4 months). At the last follow-up, according to Gartland and Werley score of the functional recovery of wrist, all except 3 patients had excellent or good results (the excellent and good rate was 95.95%).ConclusionThe classification reflects the characteristics of ICF and may provide an important reference for choosing treatment and evaluating prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A new classification and its value evaluation for intermediate column fractures of the distal radius

Yang¹,

Yin²,

Li³

et al. 2018

J Orthop Surg Res

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“…In grade II fractures, the complication rate would be slightly higher than seen in close fractures or grade I [13]. We will appreciate a low increase in the infection rate, and patients would experience a delay in the time until full recovery [70,71]. In these situations, the use of a plate, if indicated, would not increase the infection rate [71].…”

Section: Complicationsmentioning

confidence: 99%

“…We will appreciate a low increase in the infection rate, and patients would experience a delay in the time until full recovery [70,71]. In these situations, the use of a plate, if indicated, would not increase the infection rate [71].…”

Section: Complicationsmentioning

confidence: 99%

Management of Open Fracture

Jorge-Mora¹,

Amhaz-Escanlar²,

González³

et al. 2018

Trauma Surgery

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Open fractures are common and their prevalence is increasing in elderly people. The burden of open fractures is high because of economic and social costs. Most open fractures occur in lower limbs. The use of validated protocols, will optimize our outcomes when treating open fractures. The first step began with the proper identification of the fracture characteristics and the hidden soft tissue injury. The use of an adequate and early antibiotic prophylaxis is mandatory and then, we have to perform adequate irrigation and debridement. Finally, we have to decide to temporally fix the fracture or proceed with the definitive fixation method. Recently, the creation of dedicated "orthoplastic" units has increased the outcomes in high-energy tibial fractures. These fractures should be managed in adequate trauma centers that should be used to face all the complications that will appear during the reconstruction procedure because complications can be as high as 50% in high-energy open fractures.

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“…The distal radius is the most common site of fracture in the upper extremity. 1 Dorsal comminutions are commonly observed in distal radius fractures (DRFs), because a fall with an outstretched hand is the usual injury mechanism and the dorsal cortex is weaker at the distal end of the radius than the volar cortex. 2,3 This dorsal comminution makes the treatment difficult, 4 and dorsal rim fractures sometime develop during dorsal comminution of DRF.…”

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confidence: 99%

The Effect of Displaced Dorsal Rim Fragment in a Distal Radius Fracture

2016

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Background In intra-articular fracture of distal radius, the intra-articular fragments can be divided into some specific fragments. In particular, the poor outcomes have been well documented for reduction loss of the volar lunate facet, but the effect of a displaced dorsal rim fracture has rarely been addressed. Materials and MethodsThe records of 26 patients with dorsal rim fragment displaced by more than 2 mm after volar locking plate (VLP) fixation for a dorsally displaced distal radius fracture (DRF) treated from March 2006 to March 2009 were retrospectively reviewed. Clinical assessments including grip strengths, wrist range of motions, and Disabilities of Arm, Shoulder, and Hand (DASH) scores were performed at 12 months postoperatively. Widths of the distal ends of dorsal rims were determined by preoperative computed tomography (CT). Dorsal rim fragment displacements were measured in immediate postoperative plain lateral radiographs. Radial inclination, volar tilt, and ulnar variance were measured on immediate postoperative wrist radiographs. Arthritic changes of radiocarpal joints were graded using radiographs obtained at 12 months postoperatively. Description of Technique DRFs were fixed using a VLP in the usual manner. Although DRF displacement was noticed after plate fixation, no further procedure was performed. The sizes of articular portions of dorsal rim fragments were measured arthroscopically in 5 of the 26 patients at the time of plate fixation. Results At 12 months postoperatively, mean grip strength, wrist flexion arc, and mean wrist extension arc were 86 AE 13, 87 AE 11, and 91 AE 10%, respectively, of contralateral sides. Mean forearm supination and pronation were 96 AE 8 and 99 AE 5%, respectively, of contralateral sides. Mean DASH score was 11 AE 10 points. Preoperatively, mean width of the distal end of dorsal rim fragments and mean displacements of dorsal rim fragments were 2.0 AE 0.6 and 3.0 AE 0.9 mm, respectively. Mean width of the articular portions of dorsal rim fragment by arthroscopic examination was 1.0 AE 0.4 mm. Mean radial inclination was 21 AE 4.8 degrees, mean volar angulation was 4.8 AE 3.9 degrees, and mean ulnar variance was 0.6 AE 1.8 mm at immediate postoperatively. Two patients showed grade I arthritic changes at 12 months postoperatively. Conclusions The articular portions of dorsal rim fragments measured arthroscopically were smaller than determined by CT. Furthermore, the study shows that displaced dorsal rim fragments in dorsally displaced DRFs treated by VLP do not adversely affect wrist clinical outcomes.

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Outcomes After Volar Plate Fixation of Low-grade Open and Closed Distal Radius Fractures Are Similar

Cited by 20 publications

References 21 publications

A new classification and its value evaluation for intermediate column fractures of the distal radius

A new classification and its value evaluation for intermediate column fractures of the distal radius

Management of Open Fracture

The Effect of Displaced Dorsal Rim Fragment in a Distal Radius Fracture

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