Relationship between plate removal and Soong grading following surgery for fractured distal radius

Selles, Caroline A.; Reerds, Sam T. H.; Roukema, Gert R.; Vlies, Kees H. van der; Cleffken, Berry; Schep, Niels W. L.

doi:10.1177/1753193417726636

Cited by 26 publications

(17 citation statements)

References 13 publications

(25 reference statements)

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“…Soong grade was also not shown to be significantly different between flexor tenosynovitis and all other complication groups. The divergence between our findings and the higher rates of plate removal in Selles et al 18 may be attributed to the different foci of the studies. Where this current study was targeted at flexor tendinopathy, Selles et al 18 assessed plate removal which encompassed stiffness, pain, and hardware failure.…”

Section: Discussioncontrasting

confidence: 90%

“…The divergence between our findings and the higher rates of plate removal in Selles et al 18 may be attributed to the different foci of the studies. Where this current study was targeted at flexor tendinopathy, Selles et al 18 assessed plate removal which encompassed stiffness, pain, and hardware failure. The lack of association of complications with Soong criteria may also be due to novel plate designs since the Soong grading system was created.…”

Section: Discussioncontrasting

confidence: 90%

“…Notably, this study did not find Soong grade to be reliably associated with higher complication rates. Selles et al 18 noted that there were no flexor ruptures in their study as well, but that plate removal was associated with Soong grade. Lutsky et al 19 noted that plate prominence, but not necessarily placement over the volar rim, resulted in higher rates of plate removal.…”

Section: Discussionmentioning

confidence: 74%

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Incidence of Flexor Pollicis Longus Complications Following Volar Locking Plate Fixation of Distal Radius Fractures

Cook

Baldwin

Fowler

2019

Hand (New York, N,Y.)

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Background: Distal radius fractures are among the most common orthopedic injuries presenting to emergency departments. The complications of distal radius open reduction and internal fixation (ORIF) range from paresthesia to tendon ruptures. The Soong grading system was designed to evaluate volar plate position to predict postoperative flexor pollicis longus (FPL) ruptures. This study evaluates post-distal radius volar fixation FPL ruptures and other postoperative complication rates relative to Soong grade, surgical training, and plate design. Methods: A retrospective chart review was conducted to assess recorded complications after distal radius ORIF. Soong grade was determined on postoperative radiographs. Other demographic features, along with the surgeon fellowship training and plate design, were noted. Analysis was performed via t test, χ2 test, rank sum test, and Fisher exact test. Results: A total of 522 patients met inclusion criteria. Flexor tenosynovitis was the most commonly recorded complication (21% of total complications). No FPL ruptures were recorded. Soong grades between patients with and without complications were not significantly different. Soong grades between patients with flexor tenosynovitis and other complications were not significantly different. Flexor tenosynovitis had higher odds of occurring compared with other complications when the surgeon was hand-trained or when the plate type was designed by Acumed. These higher odds were not maintained under multivariate regression analysis. Conclusion: Lack of FPL ruptures in this large series may reflect improved plate technology and increased awareness. The association between flexor tenosynovitis and hand fellowship–trained surgeons may be associated with more complex cases being referred to specialists.

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Section: Discussioncontrasting

confidence: 90%

Section: Discussioncontrasting

confidence: 90%

Section: Discussionmentioning

confidence: 74%

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Incidence of Flexor Pollicis Longus Complications Following Volar Locking Plate Fixation of Distal Radius Fractures

Cook

Baldwin

Fowler

2019

Hand (New York, N,Y.)

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“…No flexor tendon injuries were observed by Lutsky et al. (2015), Selles et al. (2018) or Cook et al.…”

Section: Discussionmentioning

confidence: 88%

“…Open reduction and palmar locking plate fixation has become one of the preferred treatment methods in patients with displaced distal radial fractures (Boretto et al., 2014; Johnson et al., 2017; Selles et al., 2018; Walenkamp et al., 2016). Flexor tendon ruptures are rare, yet serious complications (Asadollahi and Keith, 2013; Snoddy et al., 2015; Soong et al., 2011) and have been linked to distal protrusion of the plate (Orbay and Touhami, 2006; Soong et al., 2011).…”

Section: Introductionmentioning

confidence: 99%

Impact of Soong grading on flexor tendon ruptures following palmar plating for distal radial fractures

Gören

Sauerbier

Arsalan-Werner

2019

J Hand Surg Eur Vol

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The purpose of this study was to evaluate flexor tendon injuries following palmar plating of distal radial fractures relative to the Soong grade. This retrospective cohort study included 113 patients who underwent palmar plate removal after a distal radial fracture between 2010 and 2016. In 13 patients, a greater than 50% injury of the flexor pollicis longus tendon was observed. Of these, nine patients were classified as Soong grade 2, four as Soong grade 1 and none as grade 0. The difference between the Soong groups was statistically significant ( p = 0.006). Flexor tenosynovitis was present in eight patients (7%) and more likely in patients with a higher Soong grade ( p = 0.026). We conclude that higher Soong grades are associated with significantly more flexor tendon complications. Therefore, elective removal of the palmar plate after union of the fracture should be considered in patients with Soong grades 1 and 2. Level of evidence: IV

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Treatment options in extra-articular distal radius fractures: a systematic review and meta-analysis

Oijen

Lieshout

Reijnders

et al. 2021

Eur J Trauma Emerg Surg

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Purpose This systematic literature review aimed to make a detailed overview on the clinical and functional outcomes and to get insight into the possible superiority of a treatment method for extra-articular distal radius fractures. Methods Embase, Medline, Cochrane Library, Web of Science, and Google Scholar were searched for studies describing treatment results. Five treatment modalities were compared: plaster cast immobilization, K-wire fixation, volar plating, external fixation, and intramedullary fixation. Results Out of 7,054 screened studies, 109 were included in the analysis. Overall complication rate ranged from 9% after plaster cast treatment to 18.5% after K-wire fixation. For radiographic outcomes, only volar tilt in the plaster cast group was lower than in the other groups. Apart from better grip strength after volar plating, no clear functional differences were found across treatment groups. Conclusion Current literature does not provide uniform evidence to prove superiority of a particular treatment method when looking at complications, re-interventions, and long-term functional outcomes.

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Relationship between plate removal and Soong grading following surgery for fractured distal radius

Cited by 26 publications

References 13 publications

Incidence of Flexor Pollicis Longus Complications Following Volar Locking Plate Fixation of Distal Radius Fractures

Incidence of Flexor Pollicis Longus Complications Following Volar Locking Plate Fixation of Distal Radius Fractures

Impact of Soong grading on flexor tendon ruptures following palmar plating for distal radial fractures

Treatment options in extra-articular distal radius fractures: a systematic review and meta-analysis

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