Role of a spanning plate as an internal fixator in complex distal radius fractures

Beeres, Frank J. P.; Liechti, Rémy; Link, Björn‐Christian; Babst, Reto

doi:10.1007/s00064-020-00686-4

Cited by 10 publications

(4 citation statements)

References 23 publications

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“…All patients need cast immobilization after frame removal till the full union achieved radiologically and clinically. This was agreed with Beeres et al (9) who reported that the external fixator frame continued for 4 to 6 weeks, and their results was comparable with our results as the satisfactory outcome was in 45% of patients had good results. 45% fair and 10% had poor outcome.…”

Section: Discussionsupporting

confidence: 93%

“…On the other hand Beeres et al (9) documented that the mean union time was 8 weeks, most of them (75%) had fracture united in the first two months, while the rest need longer period with no case of delayed or non union. This results was better than our results due to compination in their study between external fixator and locked T-Plate internal fixation for comminuted distal radial fractures.…”

Section: Discussionmentioning

confidence: 98%

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Treatment of Comminuted Distal Radius Fractures Using Spanning External Fixator

Abdelsala¹,

Metwally²,

Kader³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: Distal radius fractures are common orthopedic injuries with a bimodal age distribution, affecting young patients following high-energy trauma and elderly patients with osteoporotic bone following low-energy falls. Objectives: The aim of the study was to understand the advantages and disadvantages of spanning external fixation technique for treatment of comminuted distal radius fractures. Patients and methods: This Prospective Cohort study was conducted in Orthopedic Surgery Department, Zagazig University Hospitals, Egypt on twenty-four patients with comminuted distal radius fractures treated by spanning External Fixator, during the period from January 2021 to December 2021. Result: All patients achieved the full union; only 2 patients had delayed union beyond the 3 months. According to MMWS, 50% of patients had excellent outcome, 29.2% had good, while fair and poor outcome occurred in 12.5% & 8.3% respectively. Regarding the Complications, ten patients developed complications, most of them were minor complications, while 2 patients developed Delayed union and one patient had DRUJ instability. Conclusion:It could be concluded that spanning external fixation is a good option for treatment of intra-articular DRF. The good outcomes achieved in this study suggest that use of the Spanning external fixators could be an alternative treatment method for intra articular distal radius fractures, as it is easier, need less operation time, decrease amount of blood loss and decrease risk of infection in comparison with spanning bridging plate or locked distal radius plates. All DRFs achieved good results; Functional outcomes were promising, including wide wrist ROM and no mal or non-union occurred.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 98%

Treatment of Comminuted Distal Radius Fractures Using Spanning External Fixator

Abdelsala¹,

Metwally²,

Kader³

et al. 2022

The Egyptian Journal of Hospital Medicine

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“…Arthrodesis may still be a secondary option. Temporary internal fixation using spanning plates is another alternative for non-reconstructable DRFs [ 31 ]. However, in elderly patients this two-stage operation on one hand is prone to a higher perioperative risk (anesthesia risk, postoperative delirium, etc.)…”

Section: Discussionmentioning

confidence: 99%

Lessons learned with the Cobra prosthesis in elderly patients with complex distal radius fractures—a retrospective follow-up study

Benedikt

Kaiser

Schmidle

et al. 2021

Arch Orthop Trauma Surg

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Introduction Recently, the Cobra prostheses were introduced in the treatment of distal radius fractures (DRF) of elderly patients. Fracture prostheses provide an alternative treatment option for complex fractures where conservative therapy seems not acceptable and osteosynthesis seems not possible. Data reporting the feasibility of the Cobra prosthesis are sparse. Therefore, this retrospective follow-up study investigated the clinical and radiological mid-term outcome of the Cobra implant in complex DRFs of elderly patients. Materials and methods Thirteen patients (mean age 73.5 years, range 65–87 years) were retrospectively evaluated with at least a 1-year follow-up after surgery. Objective and subjective clinical parameters as well as the radiological outcome and complications were analyzed. Results The mean follow-up period was 31.2 months. Seven cases required a cemented prosthesis. The mean relative range-of-motion compared to the healthy side was 72.3% and 51.8% for extension and flexion, respectively, and 87.9% and 85.7% for pronation and supination, respectively. The mean grip strength was 78.3% compared to the non-operated side. Eight patients were very satisfied, five patients were partly satisfied with the result. The DASH, PRWE, MHQ and Lyon-Scores averaged 39.1, 36.2, 64.9 and 63.3 points, respectively. The mean VAS-Score for pain was 1.1 at rest and 3.2 during activities. Perioperative complications included one dissection of the extensor pollicis longus tendon, one heterotopic ossification, one radiocarpal dislocation and two cases of an ulnar impaction syndrome due to implant subsidence. Conclusion The prosthetic treatment of complex DRFs in elderly patients with the Cobra implant led to clinically and radiologically satisfactory mid-term results. The Cobra prosthesis still does not represent a gold standard but can be regarded as a feasible salvage option for complex DRFs when osteosyntheses may not be possible and non-operative treatment will lead to further functional restrictions and wrist pain during performing activities of daily life in high functional demand patients.

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“…39,40 Two were in a foreign language, 41,42 six did not include DP patients, [43][44][45][46][47][48] four were previous reviews, 16,[49][50][51] and three had a small population. 14,19,52 Two papers had potential overlap with a subsequent paper 53,54 and were excluded to prevent duplication of patients, and two papers discussed a surgical treatment/technique summary 55,56 (►Fig. 1).…”

Section: Systematic Reviewmentioning

confidence: 99%

Bridge Plate Distraction for Complex Distal Radius Fractures: A Cohort Study and Systematic Review of the Literature

Esworthy,

Shaji,

Duraku

et al. 2023

J Wrist Surg

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Background Dorsal bridge plating (DP) of the distal radius is used as a definitive method of stabilization in complex fracture configurations and polytrauma patients. Questions/Purposes This review aims to summarize the current understanding of DP and evaluate surgical outcomes. Methods Four databases were searched following the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and registered with PROSPERO. Papers presenting outcome or complication data for DP were included. These were reviewed using the National Institutes of Health Quality Assessment and Methodological Index for Non-Randomised Studies tools. Results were collated and compared to a local cohort of DP patients. Results Literature review identified 416 patients with a pooled complication rate of 17% requiring additional intervention. The most prevalent complications were infection/wound healing issues, arthrosis, and hardware failure. Average range of motion was flexion 46.5 degrees, extension 50.7 degrees, ulnar deviation 21.4 degrees, radial deviation 17.3 degrees, pronation 75.8 degrees, and supination 72.9 degrees. On average, DP removal occurred at 3.8 months. Quality assessment showed varied results.There were 19 cases in our local cohort. Ten displayed similar results to the systematic review in terms of range of motion and radiographic parameters. Higher QuickDASH scores and complication rates were noted. Local DP showed earlier plate removal at 2.9 months compared to previous studies. Conclusion DP is a valid and useful technique for treating complex distal radius fractures. It displays a lower risk of infection and pain compared to external fixation which is commonly used to treat similar injuries. Patients can recover well following treatment both in function and range of motion. Further high-quality studies are required to fully evaluate the technique.

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Role of a spanning plate as an internal fixator in complex distal radius fractures

Cited by 10 publications

References 23 publications

Treatment of Comminuted Distal Radius Fractures Using Spanning External Fixator

Treatment of Comminuted Distal Radius Fractures Using Spanning External Fixator

Lessons learned with the Cobra prosthesis in elderly patients with complex distal radius fractures—a retrospective follow-up study

Bridge Plate Distraction for Complex Distal Radius Fractures: A Cohort Study and Systematic Review of the Literature

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