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OBJECTIVE: To compare the efficacy of volar and dorsal plate fixation for unstable dorsal distal radius fractures. METHODS: Forty-seven cases were selected from patients undergoing surgical reduction and internal fixation treatment in our hospital from August 2006 to October 2010, with 21 males and 26 females, aged 39-73 years old. Patients were divided into two groups: volar plate fixation group (Group A) which has 32 cases, including 27 cases with locking plate, 5 cases with ordinary T plate, and 4 cases combined with dorsal Kirschner wire fixation; dorsal plate fixation group (Group B) which has 15 cases, including 7 cases with locking plate. The efficacy of the two fixation methods were compared in terms of postoperative wrist function, X-ray score, and postoperative complications. RESULTS: Compared with those of preoperative groups, the volar tilt, ulnar deviation and radial styloid height in both group A and B were significantly improved one week after surgery as shown by X-ray imaging. Comparison of X-ray images one week after surgery with those of six months after surgery showed no significant changes in volar tilt, ulnar deviation or radial styloid height. 87.5% of patients in group A and 86.7% of patients in group B got "excellent" in their wrist function assessment, and there was no significant difference between the two groups (X(2)=0.825, P=1.000). But patients in group A hax significantly lower incidence rate of postoperative complications than group B (X(2)=4.150, P=0.042). CONCLUSION: For unstable distal radius fractures with dorsal displacement, volar plate fixation can achieve satisfactory reduction results, and cause less tendon damage or other complications than dorsal plate fixation.
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INTRODUCTION: Internal fixation with hook plate has been used to treat acromioclavicular joint dislocation. This study aims to evaluate the effect of its use on shoulder function, to further analyze the contributing factors, and provide a basis for selection and design of improved internal fixation treatment of the acromioclavicular joint dislocation in the future. METHODS: A retrospective analysis was performed on patients treated with a hook plate for acromioclavicular joint dislocation in our hospital from January 2010 to February 2013. There were 33 cases in total, including 25 males and 8 females, with mean age of 48.27 ± 8.7 years. There were 29 cases of Rockwood type III acromioclavicular dislocation, 4 cases of type V. The Constant-Murley shoulder function scoring system was used to evaluate the shoulder function recovery status after surgery. Anteroposterior shoulder X-ray was used to assess the position of the hook plate, status of acromioclavicular joint reduction and the occurrence of postoperative complications. RESULTS: According to the Constant-Murley shoulder function scoring system, the average scores were 78 ± 6 points 8 to 12 months after the surgery and before the removal of the hook plate, the average scores were 89 ± 5 minutes two months after the removal of hook plate. Postoperative X-ray imaging showed osteolysis in 10 cases (30.3%), osteoarthritis in six cases (18.1%), osteolysis associated with osteoarthritis in four cases(12.1%), and steel hook broken in one case (3%). CONCLUSION: The use of hook plate on open reduction and internal fixation of the acromioclavicular joint dislocation had little adverse effect on shoulder function and is an effective method for the treatment of acromioclavicular joint dislocation. Osteoarthritis and osteolysis are the two common complications after hook plate use, which are associated with the impairment of shoulder function. Shoulder function will be improved after removal of the hook plate.
RESUMO
OBJECTIVE: To investigate the internal fixation methods in the two different surgical approach to the unstable distal radius fractures. METHODS: From August 2006 to October 2010,47 patients with distal radius fractures were treated with open reduction and plate internal fixation. Among the patients, 21 patients were male and 26 patients were female,ranging in age from 39 to 73 years old. All the patients were divided into two groups: 32 patients were treated with plate fixation at the palm side with palm side incision (group A),including locking plate used in 27 patients and ordinary T shape plate used in 5 patients; 15 patients were treated with dorsal plate fixation (group B), including locking plate used in 7 patients and ordinpry T shape plate used in 8 patients. The postoperative wrist function, X-ray score,complications were compared between the two groups. RESULTS: Compare to preoperative, postoperative volar tilt,ulnar deviation and radial styloid height of both groups improved; and comparison between 1 week after operation and 6 months after operation,volar tilt,ulnar deviation and radial styloid height of both groups had no obvious loss. In group A, 1 patient had tension injury of median nerve, 1 patient had incision infection, 2 patients had adhesion of tendon; and in group B,1 patient had incision swelling and infection, 1 patient had adhesion of tendon,3 patients had stimulation of extensor pollicis longus muscle tendon. The complication occurrence rate of group A is lower than that of group B. The wrist functional assessment: 17 patients got an excellent results, 11 good, 3 poor and 1 bad in group A; and 8 excellent, 4 good, 2 poor and 1 bad in group B. There was no statistically significant difference of wrist function between the two groups. CONCLUSION: Plate fixation at the palm side for the treatment of unstable distal radius fractures can also achieve a good reduction,and has less complication such as tendon damage than that of dorsal plate fixation.
