«Placa cerrada palmar para el tratamiento de fracturas de radio proximal con luxación dorsal e inestable.»
R. Arora1 , M. Lutz1, D. Fritz1, R. Zimmermann1, J. Oberladstätter1 and M. Gabl1
(1) Department of Trauma Surgery and Sports Medicine, Medical University Innsbruck (MUI), Anichstrasse 35, 6020 Innsbruck, Austria
Introduction This study investigates the clinical and radiological results of open reduction and internal fixation of unstable distal radial fractures using a palmar placed interlocking plate system with no substitutes for treatment of the dorsal metaphyseal fracture void.
Materials and methods Nineteen patients with a mean age of 61 years (range 4978 years) and a dorsally displaced distal radial fracture were treated using a palmar placed 2.4 mm interlocking plate system. All 17 women and 2 men were followed up according to the study protocol. Standardised radiographs in anteroposterior and lateral projection were performed before reduction and at 2, 6, 12 and 24 weeks after surgery. Radiological measurements included palmar tilt, radial inclination and radial shortening as defined by ulnar variance and intra-articular steps. Clinical assessment included active range of motion (ARM) of the wrist, pain according to a visual analogue scale (VAS), grip power, working ability, Disability of Arm, Shoulder and Hand-Score (DASH Score) and Mayo Wrist Score.
Results At final follow-up after a minimum of 11 months, the palmar tilt was +1°, radial inclination 19.8° and ulnar variance 1.0 mm. Mean loss of palmar tilt measured 1.9°, radial inclination 1.3° and ulnar variance 0.4 mm. Mean wrist extension measured 58°, wrist flexion 41°, pronation 83° and supination 84°. The Mayo Wrist Score showed 21% excellent, 58% good, 16% fair and 5% poor results.
Conclusion The treatment of unstable, dorsally dislocated, distal radius fractures AO types A3, C1 and C2, with a palmar placed 2.4 mm interlocking plate system and without additional treatment of the metaphyseal defects showed good radiological and functional results with minimal loss of reduction.
Archives of Orthopaedic and Trauma Surgery. Issue: Volume 125, Number 6. July 2005. Pages: 399 – 404.