Palmare winkelstabile Plattenosteosynthese der instabilen distalen Radiusfraktur

Abstract

Internal fixation of distal radius fractures often shows the problem of secondary dislocation due to dorsal comminution and osteoporosis. Although dorsal plating systems provide good stabilization, the intraoperative control of reduction is difficult in the comminuted area with high incidence for the need of cancellous bone graft. Occurrence of extensor tendon complications including tendonitis and rupture is not uncommon. The use of fixed angle devices by a palmar approach has demonstrated the advantage of better visualization and control at the fracture side. The subchondrale support of the articular surface by fixed angle pegs or screws prevents secondary dislocation allowing early mobilization. Better soft tissue coverage is associated with a low complication rate. 62 patients (average age 55 years) were treated with different fixed angel devices according to the fracture type and underwent retrospective evaluation with mean follow-up of 11 months (6-23 months). According to the AO Classification there were 3 A2, 24 A3, 7 B3, 14 C1, 9 C2 und 5 C3 fractures. The majority beside the B3 types and one C3 fracture were dorsally displaced. All of them showed healing without relevant secondary loss of reduction. Mean DASH score reached 19 points.

Number and Locations of Screw Fixation for Volar Fixed-Angle Plating of Distal Radius Fractures: Biomechanical Study

“…Despite the availability of anatomically shaped plates, there is a risk of intra-articular screw placement. 9 In comminuted fractures, the subchondral bone support might be insufficient, with secondary loss of reduction despite angular stable fixation. Multidirectional angular plates that allow screw placement within 2 rows in the distal fragment were developed to prevent this.…”

Strategie der Radiusfrühkorrektur

“…Durch die Entwicklung der neuen win kelstabilen Plattensysteme ist es möglich, unabhängig von Knochenqualität [13] und Alter der Fraktur eine stabile Osteosyn these [14] und anatomische Verhältnisse am Radius wieder herzustellen, die für das klinische Ergebnis wichtig sind [15].…”

Fractures du radius distal à déplacement dorsal : corrélation entre scores fonctionnels, qualité de réduction et type de fixation

“…Mais dans l'étude, les reculs ne sont pas les mêmes et en particulier pour les plaques antérieures et broches qui sont moins importants que pour les plaques postérieures (respectivement 21, 17 et 48 mois). En revanche, l'étude a été réalisé avec des plaques antérieures à vis non verrouillées alors que diverses séries s'accordent à dire que les plaques à vis verrouillées maintiennent encore mieux la réduction obtenues [16,17]. Cela renforce nos résultats de meilleure conservation de l'index radio-ulnaire pour les plaques antérieures.…”