Implant Selection for Treatment of Distal Radius Fractures / 대한정형외과학회잡지

ABSTRACT

Anatomical reduction is essential for successful treatment of distal radius fractures. In-depth understanding of the implant is mandatory in order to obtain adequate fixation of the fracture fragments and to avoid implant-related complications. Selection of an improper implant and screw length may lead to rupture of flexor or extensor tendon as a complication. This article will briefly discuss the pros and cons of the traditional fixation methods such as percutaneous pin fixation and external fixation, and will focus on the recent development of the volar locking plate. Variable-angle locking plate, which was introduced in an effort to provide surgeons with more freedom for fixation, may have inadequate fixation strength if screw locking is repeated. From the biomechanical study, at least four distal locking screws are enough to have strength to maintain fracture fixation. Measuring screw length may be difficult; therefore, information about the ratio of the metaphysis and diaphysis will be helpful in deciding on the proper screw length. Locking screws are recommended as they are stronger than locking pegs. In order to avoid flexor tendon ruptures, the plate should not be placed too far distally.