Radiographic Alignment of Unstable Distal Radius Fractures Fixed With 1 or 2 Rows of Screws in Volar Locking Plates

Neuhaus, Valentin; Badri, Omar; Ferree, Steven; Bot, Arjan G.J.; Ring, David; Mudgal, Chaitanya S.

doi:10.1016/j.jhsa.2012.10.040

Cited by 21 publications

(12 citation statements)

References 19 publications

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“…A second distal screw row does not have any positive influence on postoperative radial shortening. This is in accordance with biomechanical studies[ 12 , 14 , 24 - 26 ].…”

Section: Discussionsupporting

confidence: 93%

Screw placement is everything: Risk factors for loss of reduction with volar locking distal radius plates

Drobetz

Black

Davies

et al. 2018

WJO

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AIMTo determine factors correlated with postoperative radial shortening in patients with distal radius fractures treated with volar locking distal radius plates.METHODSA total of 250 patients with a distal radius fracture stabilised with volar locking plates between January 2010 and December 2014 were included in a multicentre retrospective cohort study. We measured the distance of the distal locking screws to the joint line immediately postoperatively and then measured radial shortening after six to eight weeks using the change in ulnar variance.RESULTSMultivariate linear regression analysis showed that there was a significant linear association between the distance of the screws from the joint line and radial shortening. No other patient, injury, or treatment-related characteristic significantly influenced radial shortening in multivariate analysis.CONCLUSIONDistal locking screws should be placed as close as possible to the subchondral joint line to prevent postoperative loss of reduction.

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“…A second distal screw row does not have any positive influence on postoperative radial shortening. This is in accordance with biomechanical studies[ 12 , 14 , 24 - 26 ].…”

Section: Discussionsupporting

confidence: 93%

Screw placement is everything: Risk factors for loss of reduction with volar locking distal radius plates

Drobetz

Black

Davies

et al. 2018

WJO

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“…Matching was used in 5(14%) studies. Age and sex were variables matched in 4 studies (23, 24, 33, 34). Although more statistically advanced, few studies (14%) used post hoc analysis to adjust for confounding (17, 19, 35, 36).…”

Section: Resultsmentioning

confidence: 99%

“…Matching reduces the chance that any observed differences are a result of the matched variables (5,7). Neuhaus et al compared volar angulation in patients treated with a single versus 2 rows of distal screws after volar locked plate fixation for distal radius fractures (23). The case-matched study found no advantage with either method.…”

Section: Discussionmentioning

confidence: 99%

The Quality of Control Groups in Nonrandomized Studies Published in the Journal of Hand Surgery

Johnson¹,

Malay²,

Chung³

2015

The Journal of Hand Surgery

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Purpose To evaluate control group selection in non-randomized studies published in the Journal of Hand Surgery American (JHS). Methods We reviewed all papers published in JHS in 2013 to identify studies that used non-randomized control groups. Data collected included type of study design and control group characteristics. We then appraised studies to determine if authors discussed confounding and selection bias and how they controlled for confounding. Results Thirty-seven non-randomized studies were published in JHS in 2013. The source of control was either the same institution as the study group, a different institution, a database, or not provided in the manuscript. Twenty-nine (78%) studies statistically compared key characteristics between control and study group. Confounding was controlled with matching, exclusion criteria, or regression analysis. Twenty-two (59%) papers explicitly discussed the threat of confounding and 18(49%) identified sources of selection bias. Conclusions In our review of non-randomized studies published in JHS, papers had well-defined controls that were similar to the study group, allowing for reasonable comparisons. However, we identified substantial confounding and bias that were not addressed as explicit limitations, which might lead the reader to overestimate the scientific validity of the data. Clinical relevance Incorporating a brief discussion of control group selection in scientific manuscripts should help readers interpret the study more appropriately. Authors, reviewers, and editors should strive to address this component of clinical importance.

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“…Crosby et al 22 found that plates with two rows of screws resisted displacement significantly better than single-row plates. Likewise, Neuhaus et al 24 found no significant difference in secondary fracture displacement between single-row and multirow groups in a clinical setting on radiographic analysis. Conversely, Drobetz et al 23 compared fixed-angle, single-row plates with variable-angle, multirow plates, and found that distal row screws do not significantly improve construct stiffness or resistance to fracture displacement.…”

Section: Single Compared With Multirow Platesmentioning

confidence: 95%

Distal radial fractures

Floccari

Dennison

2014

Current Orthopaedic Practice

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The rate of operative treatment of distal radial fractures has risen significantly over the past 2 decades. Technological advancements in plating options have contributed to this trend. Volar locking plates have rapidly gained popularity as the technique of choice, but recent literature suggests that volar locking plates only provide short-term benefit with faster recovery of function but equivalent clinical results at 1 yr when compared with external fixation and pins. Volar locking plates do result in improved radiographic results, so longer-term studies are needed for further analysis. Dorsal plating provides improved exposure of the articular surface, and newer generation lowprofile dorsal plates have lower tendon-related complication rates. Dorsal spanning plates often are used in polytrauma patients with severe intraarticular fractures to restore length and alignment while facilitating immediate unrestricted use of the hand. Fragment-specific fixation uses customizable implants to assist with anatomic reduction of multifragmented, intraarticular fractures of the distal radius. Here, we provide an overview of literature published from 2013--2014 concerning volar, dorsal, fragment-specific, and spanning plate fixation, complications, and technological updates for the surgical treatment of distal radial fractures.

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Radiographic Alignment of Unstable Distal Radius Fractures Fixed With 1 or 2 Rows of Screws in Volar Locking Plates

Cited by 21 publications

References 19 publications

Screw placement is everything: Risk factors for loss of reduction with volar locking distal radius plates

Screw placement is everything: Risk factors for loss of reduction with volar locking distal radius plates

The Quality of Control Groups in Nonrandomized Studies Published in the Journal of Hand Surgery

Distal radial fractures

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