Functional Outcome of Unstable Distal Radius Fracture with Dorsally Displaced Radial rim Treated with Volar Variable Angle Locking Compression Plate

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

Failed Extensor Indicis Proprius Tendon Transfer for Extensor Pollicis Longus Tendon Rupture after Distal Radial Fracture

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.

Rupture of the Extensor Pollicis Longus Tendon at the Proximal Screw of Volar Plate Fixation for Distal Radius Fracture: A Case Report

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.

Multiple Flexor Tendon Injuries after Volar Plate Fixation for Distal Radius Fracture: Two Cases Report

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.

Surgical Treatment of Dorsally Displaced Unstable Distal Radius Fracture with Volar Plate Fixation / 대한정형외과학회잡지

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.