ABSTRACT
Objective To study the importance of radial height restoration in the type C distal radial fractures and selection of therapeutic method.Methods Sixty-one cases of type C distal radial fractures in the department of joint orthopedics and traumatic orthopedics of affiliated traumatic and orthopedic hospital of Guangzhou university of Chinese medicine from June 2013 to September 2015 were retrospectively analyzed, including 34 cases of C1 type,14 cases of C2 type and 13 cases of C3 type according to the AO/ASIF fracture classification, the cases were divided into the manual reduction and splint external fixation group (27 cases), external fixator group (18 cases) and plate screw internal fixation group (16 cases).The radial height, palm inclination angle, ulnar inclination angle and Gartland-Werley (G-W) score after treatment were compared among various groups.Results Fifty-eight cases were followed up.The radial height, ulnar inclination angle and G-W score had statistical difference among 3 groups (P0.05);the difference of radial height and ulnar inclination angle between the external fixator group and plate screw internal fixation group had no statistical significance (P>0.05), but there were statistically significant differences when these two groups were compared with the manual reduction and splint external fixation group respectively (P0.05) , but there were statistically significant differences when these two groups were compared with the the plate screw internal fixation group respectively (P<0.05).Conclusion The radial height restoration may better recovery ulnar inclination angle and improve the joint function.
ABSTRACT
BACKGROUND:Distal radius C fractures belong to multiple fractures in the joint. Its treatment should recover various angles and joint surface continuity outside the joint. The recovery of palmar tilt angle, radial inclination angle and radial height is also very important for treating distal radius. OBJECTIVE:To study the changes in palmar tilt angle, radial inclination angle and radial height after type C fractures of the distal radius repaired with Acu-Loc(R)2 VDR bone plate system. METHODS:From May 2015 to March 2016, 11 cases of type C distal radial fractures were treated with Acu-Loc(R)2 VDR bone plate system. Preoperatively, the palmar tilt angle was-31° to-4° (-12.45° on average), and the radial inclination angle was 6° to 18° (11.18° on average), and the radial height was 1.92 mm to 8.68 mm (5.28 mm on average). X-ray films were observed at postoperative 4, 8 and 12 weeks and half a year in all patients. Palmar tilt angle, radial inclination angle and radial height were measured and observed using anteroposterior and lateral X-ray films during final follow-up. Wrist function was assessed with Gartland-Werley score. RESULTS AND CONCLUSION:(1) 11 patients were followed and the postoperative follow-up ranged from 7 months to 15 months. X-ray films showed that the union of fractures was achieved in 6-8 weeks (6.5 weeks on average). No infection or internal fixation failure occurred. The articular facets were smooth in 10 patients and a little poor was found in 1 case (<2 mm). (2) After operation, the palmar tilt angle was 8° to 15° (11.55° on average) (P<0.05);the radial inclination angle was 22° to 27° (23.18° on average) (P<0.05);the radial height was 8.01 mm to 13 mm (11.03 mm on average) (P<0.05). (3) The results were excellent in 8 cases, good in 2 cases, and poor in 1 cases according to Gartland-Werley wrist function assessment;the excellent and good rate was 91%. (4) Acu-Loc(R)2 VDR bone plate fixation can provide reliable fixation and effective support for type C distal radius fractures, which can recover the palmar tilt angle, the radial inclination angle and the radial height, so the Acu-Loc(R)2 VDR bone plate is an ideal method to treat type C fractures of the distal radius.