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@#Introduction: The purpose of this study is the evaluation of radial collapse, based on the number of screws used in the metaphyseal region and by distal dorsal distance (DDD) and lunate facet distance (LFD) measurement. Materials and methods: Between 2015 and 2019, 60 patients who were being treated with volar locking plates due to isolated distal radius fracture were evaluated. Control radiographs were taken on the first day and at 3rd-, 6th- and 12th-month follow-ups. Distal dorsal cortex distance and lunate facet distance were measured in the lateral radiographs. The number of screws used in the metaphyseal region was also evaluated. According to the number of screws, the amount of collapse was analysed based on both the LFD and the DDD. Results: The mean age of patients was 43.5±12.7 years. Thirty-three of the patients included in the study were male and 27 were female, and the minimum follow-up period was one year. According to the mean number of screws, groups were defined as up to 6 screws or 7 screws and above. There was a statistically significant difference between the groups in terms of DDD collapse at the 6th-month and 12th-month follow-ups (p<0.005). It was observed that the radial collapse and decrease in DDD and LFD were lower in plates with seven screws and above. Conclusion: Decreases in either DDD or LFD, or radial collapse were observed less in patients who had seven or more metaphyseal screws inserted. These findings might be useful for surgeons treating distal radius fractures to reduce radial collapse.
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Las fracturas del radio distal están entre las patologías más comunes en el área de la emergencia, actualmente los tratamientos más utilizados son la fijación con alambres de Kirschner y fijador externo (AKFE), o la osteosíntesis con placas volares de estabilidad angular (PVEA), realizamos un estudio comparativo de los resultados a corto plazo entre ambos métodos. Se realizó un estudio transversal, retrospectivo y descriptivo desde el 2005 al 2019, donde se revisaron las historias de los pacientes con fracturas de radio distal tratados con AKFE o PVEA, evaluando el alta después de la medición de la amplitud de movimiento articular funcional. Se incluyeron 68 pacientes, 47(69,11%) pacientes tratados con PVEA y 21(30,88%) con AKFE, la edad promedio fue de 53,07 años, la causa más común fue la caída de su altura en 60,29% casos, el alta médica por mejoría se realizó a las 15,95 semanas para AKFE y a las 9,86 semanas para PVEA (<0.05). La osteosíntesis con PVEA evidenció un menor tiempo de recuperación de la amplitud de movimiento articular con respecto a los pacientes tratados con AKFE(AU)
Fractures of the distal radius are among the most common pathologies in the emergency area, currently the treatment more frequently used are fixation with Kirschner wires and external fixator (KWEF), or osteosynthesis with angular stability volar plates (FAVP), we carried out a comparative study of the short-term results between both methods. This is a cross-sectional, retrospective and descriptive study from 2005 to 2019, where the histories of patients with distal radius fractures treated with KWEF or FAVP revised, evaluated, evaluating at discharge after functional joint range of motion was measured.68 patients were evaluated, 47 patients treated with FAVP and 21 with KWEF, average age of 53.07 years, the most common cause was the fall from his height with 60.29%, the medical discharge was made at 15,95 weeks for KWEF and 9,86 weeks for FAVP; with a t student<0.05 between them. Osteosynthesis with FAVP evidenced a shorter recovery time for joint range of motion compared to patients treated with KWEF(AU)
Subject(s)
Humans , Male , Female , Middle Aged , Bone Wires , External Fixators , Fracture Fixation, Internal , Wrist Fractures/surgery , General SurgeryABSTRACT
Objective:To evaluate the role of high frequency ultrasonography in diagnosis of closed volar plate injury of proximal interphalangeal joint.Methods:From May 2015 to may 2021, 41 patients with acute closed volar plate injury confirmed by Department of Hand and Foot Surgery of the Provincial Hospital Affiliated to Shandong First Medical University were examined by high frequency ultrasonography. The sonographic features were analyzed and classified.Results:High frequency ultrasonography could not only clearly show the thickness, shape and echo of volar plate, but also the degree of injury and avulsion fracture of volar plate, according to which the closed volar plate injury could be divided into three types: A, B and C. Type A(13 cases): Avulsion fracture of the middle phalangeal base was found with volar plate rupture, the sonogram showed that the continuity of the volar plate attachment of the middle phalangeal base was interrupted, and avulsion fracture was found at the distal end of the volar plate. Type B(11 cases): Complete rupture of the volar plate attachment of the middle phalangeal base was found without avulsion fracture, the sonogram showed that the continuity of the volar plate attachment of the middle phalangeal base was interrupted, and the end of the volar plate contracted and thickened. Type C(17 cases): Tear of the volar plate was found, the sonogram showed enlarging volar plates, heterogeneous internal echo, and liquid dark area was visible in some cases. The average thickness of the three types of closed volar plate injury of the proximal interphalangeal joint measured by ultrasound was (0.33±0.05)cm, and the average thickness of the volar plate at the same position of the corresponding finger on the opposite side was (0.22±0.03)cm. There was significant difference between the two groups ( t=7.864, P=0.006). Conclusions:High frequency ultrasonography is the preferred imaging examination method for the diagnosis of closed volar plate injury in proximal interphalangeal joint, which has an important guiding significance for the selection of clinical treatment.
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PURPOSE@#Comminuted intraarticular distal radial fractures are difficult to treat conservatively and require operative treatment. This study compared the functional outcomes between variable angle volar plating and external fixator with K-wire augmentation in open reduction and internal fixation.@*METHODS@#A total of 62 adult patients with comminuted intraarticular distal radius fracture were randomized into 2 groups: volar plate group and external fixator group. These patients aged between 18 and 60 years had unilateral fractures, and agreed to be included in the study. Patients with a history of fracture, bilateral fracture, associated other injuries, delayed injury for more than 2 weeks, open fracture, pre-existing arthrosis or disability, psychiatric illness and pathological fracture were excluded. Patients were followed up at 6 weeks, 3 months, 6 months and 1 year. The assessment of pain, functional activity, range of motion and grip strength was done at each stage of follow-up. The pain and functional activities were assessed by patient rated wrist evaluation (PRWE) score and disabilities of the arm, shoulder and hand (DASH) score.@*RESULTS@#Patients in volar plate group had superior PRWE score and DASH score at each stage of follow-up. At 1 year follow-up, the mean PRWE score were 7.48 for volar plate group and 7.35 for external fixator group; while the mean DASH score was 4.65 for volar plate group and 5.61 for external fixator group. They had better flexion and extension range of movement. They also had better pronation and supination range of motion at initial follow-up, however the difference get attenuated by 1 year. Volar plate group had significantly better grip strength than external fixator group. Complication rates were higher in external fixation group.@*CONCLUSION@#Fixation with variable angle volar plate results in early wrist mobilization, better range of movement, less pain and disability and early return of function.
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Introduction: Distal radius is one of the common fracture sites of the human skeleton. Dorsally displaced distal radius fractures(DRFs) are the most common type of DRF.Materials and Methods: Two matched cohorts of 20 matched patients, one with a displaced dorsal rim fracture >2 mm (Group1), and the other without a dorsal rim fracture (Group 2) were analyzed in this study with volar variable angle locking compressionplate fixation for dorsally unstable DRFs.Results: No significant difference was found between the two groups in overall wrist function or wrist pain. The mean displacementof dorsal rims in Group 1 was 3.0 mm and the mean diameter of the retained articular portion of the dorsal articular wall was2.0 mm. No significant difference was found between the two groups in terms of any radiographic parameters or the arthriticgrading of radiocarpal joints.Conclusion: These results suggest that a displaced dorsal rim fracture does not adversely affect the outcomes after the volarvariable angle locking compression plate fixation of a dorsally displaced DRF, indicating that an additional dorsal approach isunnecessary for reducing a displaced dorsal rim fracture
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Objective: To investigate the effectiveness of pronator quadratus muscle sparing in volar plate fixation for unstable distal radius fracture in adults. Methods: The clinical data of 62 cases of unstable distal radius fractures between January 2017 and December 2018 were retrospectively analyzed. According to the different methods of intraoperative exposure, the patients were divided into the observe group (28 cases with the pronator quadratus muscle sparing surgery) and the control group (32 cases with cutting the pronator quadratus muscle in operation and repairing it after volar plate fixation). There was no significant difference in general data such as gender, age, handedness, cause of injury, fracture classification, time from injury to operation, visual analogue scale (VAS) score, and range of motion (ROM) of wrist (flexion, extension, pronation, and supination) before operation between the two groups ( P>0.05). The operation time, intraoperative blood loss, postoperative hospital stay, fracture healing time, and postoperative complications were recorded and compared between the two groups. VAS score and ROM of wrist of two groups before operation and at 3 days and 3 months after operation were calculated and compared. The wrist function was evaluated according to the Krimmer evaluation criteria at 6 months after operation. Results: There was no significant difference in operation time and intraoperative blood loss between the two groups ( P>0.05). The postoperative hospital stay and fracture healing time of the observe group were significantly shorter than those of the control group ( P0.05). At 6 months after operation, according to Krimmer evaluation criteria, the wrist function of the observe group was excellent in 21 cases and good in 7 cases, with an excellent and good rate of 100%; and the wrist function of the control group was excellent in 22 cases, good in 11 cases, and fair in 1 case, with an excellent and good rate of 97.1%. There was no significant difference in wrist function between the two groups ( χ2=1.344, P=0.511). One case of poor incision healing occurred in the observe group, and 7 cases of poor incision healing and 5 cases of tendon pain occurred in the control group after operation. The incidence of postoperative complications was less in the observe group (3.6%) than in the control group (35.3%) ( χ2=9.325, P=0.002). Conclusion: It is feasible of the pronator quadratus muscle sparing in the volar plate fixation for unstable distal radius fracture in adults. It is beneficial to recover wrist function early after operation, reduce postoperative complications, shorten the length of hospitalization, protect the soft tissue of fracture site, and promote fracture healing.
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Purpose:@#Fractures of distal radius are one of the common orthopaedic injuries. Placing the plate on volar surface requires release of underlying pronator quadratus (PQ) muscle. No consensus is present in the literature about the repair or not of the PQ. The purpose of this study was to evaluate the influence of PQ repair on functional outcome and complications.@*Methods:@#Retrospectively 83 patients of distal radius fractures managed with volar plating between 2014 and 2016 were evaluated. Demographic data, operative notes and physical therapy records were retrieved. Patients were divided into group A where PQ repair was done and group B where no repair was done. Functional data such as range of motion (ROM), grip strength, visual analogue scale (VAS) score and disabilities of arm, shoulder and hand (DASH) score at 4 weeks, 3 months, 6 months and finial follow-up were retrieved.@*Results:@#Totally 63 patients (n = 29 in group A and n = 34 in group B) with the mean age of 51.64 years were examined. Patients were followed up for a mean of 35.2 months (range 27.2-47.1 months) in group A and 38.6 months (range 28.6-51.0 months) in group B. Though functional outcome of the affected limb was not significantly different between two groups after 3 months, PQ repair did affect the recovery at an early stage. Repair group had significantly better ROM (p = 0.0383) and VAS score at 4 weeks (p = 0.017) while grip strength (p = 0.014) was significantly better at 3 months.@*Conclusions:@#Repair of PQ may provide pain relief and increased ROM in early postoperative period and hence every attempt should be made to achieve the repair.
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Objective To investigate the treatment and surgical results of acute volar plate avulsion fracture of proximal interphalangeal joint.Methods From August 2013 to June 2016,data of 15 cases of acute volar plate avulsion fracture of proximal interphalangeal joint were retrospectively analyzed.There were 8 males and 7 females aged 18-43 years old with an average of 28.6 years old.There were 4 cases of index finger,6 cases of middle finger,2 cases of ring finger and 3 cases of little finger.Eight injuries resulted from falls,four from finger breaking and three from crushing.The time from injury to operation was 5-9 days,with an average of 6.7 days.The acute volar plate avulsion fracture of proximal interphalangeal joint were treated by double thread compression suture fixation,and Kirschner wires were used to obliquely fix the interphalangeal joint.After the operation,the fore arm was fixed by plaster for 3-4 weeks.After the removal of the plaster,the flexion and extension function of the distal interphalangeal joint and the metacarpophalangeal joint was performed under the guidance of the rehabilitation instructor in a state of no weight.The finger was evaluated by X-ray every 2 weeks until the fracture healing.After 5-8 weeks,the Kirschner wire was removed when the fracture line disappeared,and the active flexion and extension of the proximal interphalangeal joint was guided by the rehabilitation instructor.Resuts In this group of 15 patients,all the incisions healed at the first stage.There was no surgical complications such as skin necrosis,and needle path infection and no abnormal finger feeling or blood circulation disorder.All patients were followed up for 8-32 months (mean,21.7 months).8 months after operation,the DASH score was 1.5 to 7.0 points with an average of 4.6 points.At the latest follow-up,there was no pain,swelling and joint contracture in the proximal interphalangeal joints.The dorsal extension of joints were stable,and the degree of active joint activity was:90°±7° of the metacarpophalangeal joint,80°±6° of the proximal interphalangeal joint,78°±7° of the distal interphalangeal joint,and 248°±22° of total active activity.According to TAM system assessment criteria:there was excellent in 12 cases,good in 2 cases,fair in 1 case,and excellent rate was 93.3％(14/15).Conclusion Double thread compression suture fixation for the treatment of acute volar plate avulsion fracture of proximal interphalangeal joints could reduce the damage to the accessory structure of the joint,and reach adequate exposure in the operationfor fixing the bone block firmly.After operation,good fracture healing and good finger function could be achieved,so the double thread compression suture fixation is an effective surgical method.
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PURPOSE: There has been few published on arthroscopy of metacarpophalangeal joint (MCPJ) despite increasingly being used worldwide. The purpose of this study was to investigate the effectiveness of arthroscopy for pathologies around MCPJ of the thumb. METHODS: Between September 2007 and June 2015, 56 patients (56 thumb) who underwent arthroscopy of the MCPJ were retrospectively studied. Preoperative diagnoses, which were made through physical examination, plain radiograph, stress radiography, ultrasound, and magnetic resonance images (MRI), were compared with arthroscopic findings. Therapeutic arthroscopic surgeries were performed according to the needs of each patient. Functional outcomes were assessed with physical examination as well as disabilities of the arm, shoulder and hand (DASH) score and Michigan Hand outcomes Questionnaire (MHQ) score at an average 7.3 months follow-up. RESULTS: Six patients who suspected with collateral ligament injuries in MRI confirmed different diagnoses under arthroscopy. At final follow-up, the mean range of flexion contracture of the MCPJ was 5°, and the mean range of further flexion was 52.7°. Grip and pinch strength averaged 87.2% and 79.3% of contralateral side. Mean DASH and MHQ score were improved from 48.1 and 44.6, preoperatively to 14.9 and 26.3, postoperatively (p<0.001, p=0.012, respectively). All patients were satisfied with their outcomes at final follow-up, except 4 patients who noted joint stiffness or chronic pain around the thumb. CONCLUSION: Our results revealed that arthroscopy is helpful for both diagnostic and therapeutic purposes of acute and chronic painful MCPJ of the thumb. However, further studies are needed to expand the applications of arthroscopy of MCPJ of the thumb.
Subject(s)
Humans , Arm , Arthroscopy , Chronic Pain , Collateral Ligaments , Contracture , Diagnosis , Follow-Up Studies , Hand , Hand Strength , Joints , Magnetic Resonance Imaging , Metacarpophalangeal Joint , Michigan , Pathology , Physical Examination , Pinch Strength , Radiography , Retrospective Studies , Shoulder , Thumb , UltrasonographyABSTRACT
Open reduction and internal fixation using volar plating for the treatment of distal radial fractures (DRFs) is becoming an increasingly popular method. Tenosynovitis of extensor tendons causes delayed extensor pollicis longus (EPL) tendon rupture which known as complication following screw penetration of the dorsal cortex after volar plating for DRFs. As the reconstructive procedure for a closed ruptured EPL tendon in minimal displaced DRF, extensor indicis proprius (EIP) transfer is widely used. However, tendon injuries of the fourth compartment, which includes the extensor digitorum communis or EIP, can be caused by screw irritation after volar plating for DRFs. We encountered a rare case of failed EIP tendon transfer for delayed EPL tendon rupture after volar plating for a DRF. Because the EIP tendon can also be damaged by screw penetration, care must be taken to use EIP tendon for treatment of delayed EPL rupture after volar plating for DRFs.
Subject(s)
Rupture , Tendon Injuries , Tendon Transfer , Tendons , TenosynovitisABSTRACT
BACKGROUND: Fracture-dislocation of the proximal interphalangeal (PIP) joint is a relatively common injury. Various treatments for fracture-dislocation of the PIP joint have been reported. In the present study, we performed open reduction through a midlateral incision using absorbable sutures to reduce the small bone fragments and performed volar plate repair. METHODS: We treated nine patients with fracture-dislocation of the PIP joint with small fractured bone fragments too small for pinning or screw fixation. Patients with volar plate injury were treated with open reduction and volar plate repair at the periosteum of the middle phalangeal bone base by the modified Kessler method using absorbable sutures. All patients were placed in a dorsal aluminum extension block splint, which maintained the PIP joint in approximately 30 degrees of flexion to avoid excessive tension on the sutured volar plate. RESULTS: At a mean final follow-up of postoperative 9 months, all patients were evaluated radiographically and had adequate alignment of the PIP joint and reduction of the displaced bone fragments. Range of motion was improved and there were no complications. CONCLUSIONS: This technique is an excellent alternative to the current method of treating patients with fracture-dislocations that include small fragments that are too small for pinning or screw fixation. It is a less invasive surgical method and enables stable reduction and early exercise without noticeable complications.
Subject(s)
Humans , Aluminum , Finger Joint , Follow-Up Studies , Intra-Articular Fractures , Joints , Periosteum , Range of Motion, Articular , Splints , Sutures , Palmar PlateABSTRACT
As volar plate fixation of distal radius fracture becomes more common, reports of ruptured extensor pollicis longus tendon by a protruding distal screw tip are also increasing steadily. Authors have experienced a rare case of ruptured extensor pollicis longus tendon at the prominent proximal screw of fixed volar plate for distal radius fracture, and we report it herein with a review of the literature.
Subject(s)
Radius Fractures , Radius , Rupture , Tendons , Palmar PlateABSTRACT
As the, injury of flexor tendons has been rarely reported rarely after volar plate fixation in the distal radius fractures. Author experienced one case with delayed rupture of flexor pollicis longus and flexor digitorum profundus of index finger caused by anterior protrusion of volar plate. We also experienced another case with delayed rupture of flexor pollicis longus and wear on flexor digitorum profundus of index finger caused by volar plate placed distally to watershed line. Proper placement of volar plate and distal shape of the plate are important to prevent multiple tendon injury.
Subject(s)
Fingers , Radius , Radius Fractures , Rupture , Tendon Injuries , Tendons , Palmar PlateABSTRACT
Objective To investigate the clinical effects,feasibility,points for attention and complications of treating distal radial fractures through minimally invasive palmar locking plate.Methods A total of 22 patients with distal radial fractures managed by minimally invasive palmar locking plate from August 2009 to August 2010 were enrolled in the study.According to AO classification,there were five patients with type A2 fractures,three with type A3,four with type B1,seven with type B3,two with type C1 and one with type C2.Two vertical or parallel palmar incisions of 2 cm long were performed.The distal transverse incision was along the proximal wrist crease,while the distal and proximal vertical incisions were close to the radial side of flexor carpi radialis.Then,palmar locking plate was inserted through deep pronator quadratus.Results Follow-up period was 10-18 months(mean,12 months).According to Dienst function evaluation criteria,the results were excellent in 13 patients,good in six,fair in three and poor in zero,with excellence rate of 86％.Complications were as follows:one patient had delayed healing of proximal wrist crease incision;one patient had numbness of thenar eminence and the symptom was disappeared three months postoperatively;two patients remained pain on ulnar side of the wrist joint;two patients had limited function of the wrist joint.Conclusions Minimally invasive palmar locking plate is safe,mini-invasive and reliable when treating distal radial fractures,which is conducive to early functional exercise.Furthermore,the method achieves satisfactory appearance of the incision which meets the minimal invasion and thus deserves clinical practice.
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OBJECTIVE: We determined the radiographic outcome of distal radius fractures with Acu-loc volar plate. METHODS: Forty-one patients were recruited between August 2009 and September 2010. There were 10 males and 31 females, with a mean age 61.2. Fractures were radiologically classification the Frykman. Fifteen fractures were group 8, eight were group 7, ten were group 6, four were group 5 and four were group 3. Distal part of the fractures was dorsally inclined in 37 wrists and inclined to volar side in four wrists. Lateral and anteroposterior radiographs taken after operated day, the fracture were compared with radiographs of the injured wrist and the differences in palmar tilt, ulnar variance; radial height; radial shift and radial inclination were measured. RESULTS: There was significant improvement in the measurements of radial height, radial inclination, volar tilt, ulnar variance and radial shift postoperatively. The radial height improved from an average of 8.5 mm (range, 3 to 15 mm) to 11.0 mm (range, 8 to 15 mm), the radial inclination improved from an average of 21.5 degree (range, 10 to 40 degree) to 28.1 degree (range, 19 to 44 degree), the palma tilt improved from an average of 12.9 degree (range, 6 to 22 degree) to 17.2 degree (range, 7 to 27 degree), the ulnar variance improved from an average of -2.3 mm (range, -6 to 4 mm) to 1 mm (range, -3 to 7 mm) and the radial shift improved from an average of 18.7 mm (range, 15 to 26 mm) to 17.3 mm (range, 12 to 21 mm). CONCLUSION: Acu-loc volar plate is a safe and effective device.
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Female , Humans , Male , Radius , Radius Fractures , Palmar Plate , WristABSTRACT
PURPOSE: To report the clinical outcomes of a volar plate reinforcing technique with free tendon grafts after sesamoid excision for the surgical treatment of subsesamoid arthritis of the metacarpophalangeal (MCP) joint of the thumb. MATERIALS AND METHODS: Eleven consecutive patients that underwent sesamoid excision and volar plate reinforcement using a palmaris longus free tendon graft were enrolled. There were 7 males and 4 females, with an average age of 46 (range, 30-56 years). Post-traumatic arthritis after a hyperextension injury of the thumb was present in 9 patients. Two patients had idiopathic arthritis. All patients were evaluated by objective and subjective criteria, the mean follow-up duration was 19 months (range, 12-35 months). RESULTS: The results were satisfactory overall (3 excellent, 7 good, 1 poor). The mean grip strength and pinch strength significantly improved from 63.0% and 51.3%, respectively, preoperatively, to 84.9% and 88.9%, postoperatively. The mean range of motion for the MCP joint was -5.9/50.9 degrees. The mean DASH and MHQ scores showed significant improvement compared to the preoperative scores. CONCLUSION: The early clinical results suggest that the described technique is a safe and effective option for subsesamoid arthritis of the MCP joint of the thumb.
Subject(s)
Female , Humans , Male , Arthritis , Follow-Up Studies , Hand Strength , Joints , Metacarpophalangeal Joint , Pinch Strength , Range of Motion, Articular , Reinforcement, Psychology , Tendons , Thumb , Transplants , Palmar PlateABSTRACT
[Objective]To preliminarily explore the method and evaluate the effect of volar LCP fixation for dorsally displaced and unstable distal radial fractures.[Method]Thirty-five patients with the fractures were treated with volar LCP combined with the techniques of K-wires and bone grafting, whose effects were evaluated preliminarily through comparing and analyzing the volar tilt, radial inclination, radial shortening and wrist function.[Result]Followed up from 9 to 24 months (average 17months), 20 patients achieved excellent, 12 good and 2 fair with 1 poor, according to Sarmiento scale.[Conclusion]Volar LCP fixation is a safe and effective treatment for unstable and dorsally displaced distal radial fractures, which could prevent reduction lost, reduce need for bone grafting and avoid tendon irritation.
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PURPOSE: This study was performed to evaluate the usefulness of volar plate fixation of dorsally displaced unstable distal radius fracture. MATERIALS AND METHODS: 48 patients with dorsally displaced unstable distal radius fracture were treated by volar plate fixation, between August 1993 and February 2003. Radial inclination, radial length and volar tilting were analyzed by radiographic evaluation. For clinical evaluation, the clinical ratings of Green and O'Brien were used. RESULTS: Radiographic analysis of extra-articular or non-comminuted intra-articular fractures (AO type A2, A3, and C1) demonstrated no significant differences in radial inclination, radial height and volar tilting between the immediate postoperative period and the last follow-up evaluation. However, in cases of comminuted intra-articular fractures (AO type C2), there were statistically significant differences. In clinical evaluation, 40 (83%) patients demonstrated excellent or good results based on the clinical ratings of Green and O'Brien. 32 (94%) of patients demonstrated excellent or good results in extra-articular (AO type A2 and A3) or non-comminuted intra-articular fractures (AO type C1) and 8 (57%) patients demonstrated excellent or good results in comminuted intra-articular fractures (AO type C2). The number of patients with complications was 4 (8%). Median nerve neuropathy developed in 2 patients, and hand and wrist stiffness in 2 patients. All cases achieved bony union. There was no implant failure or irritation. CONCLUSION: Volar plate fixation of extra-articular or non-comminuted intra-articular fractures (AO type A2, A3, and C1) was an effective treatment method for dorsally displaced unstable distal radius fractures. It provided stable fixation and allowed early postoperative rehabilitation.
Subject(s)
Humans , Follow-Up Studies , Hand , Intra-Articular Fractures , Median Nerve , Postoperative Period , Radius Fractures , Radius , Rehabilitation , Palmar Plate , WristABSTRACT
Pain, premature degenerative arthritis, stiffness and persisting subluxation are common sequalae of fracture dislocations of the proximal interphalangeal joints of the fingers. With disruption of greater than 40% of the volar articular surface of the middle phalanx, it is un- likely that congrous stable reduction can be achieved. And the most severe injuries are caused by longitudinal compression force, which drives the middle phalanx where the middle phalanx eventually comes to rest. Many authors had reported a variety of method for the treatment of the unstable fracture dislocation with no satisfactory results except Eaton(1980). In his ten years experience the volar plate arthroplasty for acute and chronic fracture dislocations got a good results with satisfactory range of motion and no pain on motion. Authors had been treated two cases of chronic fracture dislocations of the proximal interphalangeal joint with Eatons volar plate arthroplasty followed by good results in one year followed-up study.