Volar locking compression plate fixation for osteoporotic distal radius fractures in the elderly patients / 中华创伤骨科杂志

ABSTRACT

Objective To evaluate the preliminary outcome of surgical treatment of unstable distal radius fractures caused by osteoporosis in the elderly patients with open reduction and internal fixation with T-shaped locking compression plates(T-LCP).Methods From June 2003 to may 2005,13 elderly cases of comminu ted unstable distal radius fractures caused by osteoporosis were treated with op en reduction and T-LCP internal fixation.They were four males and nine females,with an average age of 74 years old(ranging from 67 to 81).According to AO classification,two cases belonged to types B2,three to type B3,two to type C1,five to type C2 and one to type C3.All of them were closed fractures.They were fixated with T-LCP through the volar approach and their dorsal soft tissues were not dissected during the operation.Osteoset,the artificial bone substitute,was implanted in one case of large bone defect.The postoperative functional recovery ranged from 6 to 30 weeks with an average of 12.3 weeks.Passive wrist motion,active finger motion and forearm rotation were encouraged immediately after surgery.Active wrist motion was suggested seven days postoperatively.Result s The 13 cases were followed up for 4 to 22 months,with an average time of 13.2 months.The X-ray pictures showed that one-stage union was achieved in all the patients,with a mean healing time of seven weeks.No such complications were found as infection,non-union,loosing of nails,carpal tunnel syndrome or medium neuritis.Their clinical outcomes were evaluated according to the modified Mcbride grading system.Nine were rated as excellent,three as good and one as fair,with their good-excellent rate being 92.3%.Conclusions T-LCP can ensure a good fixation in the treatment of unstable distal radius fractures caused by osteoporosis in elderly patients,allow the patients to do early exercise,and achieve satisfactory clinical outcome.