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

Abstract

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.

Effects of alendronate in bone repair: A study in rat femur fractures treated with plates and screws

“…A greater dosage of ALN has been proven to be more effective in qualitative microtomographic analysis of bone repair. This could be seen through the greater number of trabeculae and the decreased spacing between the trabeculae in the 3 mg/kg group (6,16,33). More bone density suggests that a higher dosage in uences bone quality, which encouraged the researchers in this experiment to use both 1 mg/kg and 3 mg/kg.…”

“…When combined with anabolic-active drugs, ALN signi cantly improves bone mineral density and reduces bone fracture (3,8,14,15). Previous research has shown that short-term ALN treatment also improves bone repair around implants installed in the tibias of osteoporotic rats, demonstrating the drug's potential therapeutic effect (16,17).…”

“…The rats were sedated for 1 minute via inhalation of iso urane (Cristália, Itapira, SP, Brazil) and after anesthetized by intramuscular injection with 10% ketamine hydrochloride (Vetbrands, Paulínia, SP, Brazil) and 2% xylazine hydrochloride (Vetbrands, Paulínia, SP, Brazil). Under anesthesia, the animals were placed in the left lateral decubitus position, and then the right pelvic member was surgically exposed and the surgery developed according to the technique described by Weiss et al (16). A 5 cm straight incision was made with No.…”

Quotation errors related to the Distal Radius Acute Fracture Fixation Trial paper

“…Quotation error Unsubstantiated 'Patients treated with VLDRP still often have their wrists immobilised postoperatively, rather than being allowed to use as tolerated' (Drobetz et al, 2018) 'Delivering full-scale multi-centre randomised controlled trials (RCT) in trauma and orthopaedics cost large amounts of funding (typically in excess of £1 M) and large amounts of time (typically 4-5 years)' (Kearney et al, 2019) 'Reoperation rates after VLP have been reported as up to 15% in some studies and 6% for CRPP' (Liao et al, 2018) '. .…”

Open Reduction & Internal Fixation of a Distal Radius Fracture with a Volar Locking Plate: A Case Report

“…Biomechanical studies comparing volar fixed-angle locking plates with that of conventional dorsal plates report volar fixed-angled plates to be superior in terms of their strength. Dorsal plating of distal radius has not garnered much popularity due to fact that, inspite of dorsal plating, the volar collapse of fracture occurred [8,[9][10][11][12][13] .…”