gms | German Medical Science

122. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

05. bis 08.04.2005, München

Treatment of Distal Radius Fractures with an Angle Fixed Bar Volar Plating System (ITS): a prospective study of 105 fractures

Meeting Abstract

  • corresponding author G. Gruber - Landeskrankenhaus Weiz, Weiz, Österreich
  • G. A. Bernhardt - Landeskrankenhaus Weiz, Weiz, Österreich
  • G. Köhler - Landeskrankenhaus Weiz, Weiz, Österreich
  • K. Gruber - Landeskrankenhaus Weiz, Weiz, Österreich

Deutsche Gesellschaft für Chirurgie. 122. Kongress der Deutschen Gesellschaft für Chirurgie. München, 05.-08.04.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05dgch2892

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgch2005/05dgch383.shtml

Published: June 15, 2005

© 2005 Gruber et al.
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Outline

Text

Introduction

The fracture of the distal radius, especially in elderly patients is one of the most common injuries in orthopedics.While most fractures of the distal radius can be treated by conservative means, unstable distal radius fractures require surgical fixation. For these fractures various methods of surgical treatment have been reported. Open reduction and internal fixation with plates is a valid treatment of displaced extra and intraarticular fractures. To our knowledge volar plating can provide stable internal fixation to allow early function and prevent secondary displacement.The purpose of this study was to evaluate the function and radiographic results regarding patient's quality of life.

Materials

This study reports a total number of 105 fractures in 102 patients, between the first of January 2002 and December the 31st 2003. Informed consent was obtained from all patients. The patients were treated with an angle fixed bar volar plating system (ITS, Implantat-Technologie-Systeme GmbH, Laßnitzhöhe, Austria). Surgical technique was performed as described in the manufacturer's manual.The follow-up examination contained a subjective, clinical and radiological part. The results were evaluated according to the scores of Gartland and Werley and the Disabilities-of-the-Arm-Shoulder-and Hand (DASH) outcome questionnaire.

Results

Ninety-three patients out of 102 with unstable distal radius fractures were evaluated after an average period of 16 months (range, 5 to 30 months). Sixty-nine patients were female and twenty-four male; the average age was 60 years (range, 17 to 91 years). Complications consisted of two tendon ruptures (long extensor pollicis muscle), one case of plate loosening, one Sudeck's dystrophy and subjective reported paresthesia in five cases. Two patients required tendon repair and in one patient the plate had to be replaced.Fracture healing progressed uneventfully with no evidence of infection. At final examination all patients were able to return to their preinjury everyday activities.According to the score of Gartland and Werley there were seventy-five excellent(80.6%), seventeen good (18.3%) and one (1.1%) fair result.The DASH outcome questionnaire averaged 7.5 points in our study.

Discussion

The primary goal in treatment of the distal radius is to achieve optimal restoration of the disrupted anatomy and allow early return to daily activity, while preventing secondary fracture displacement. Various surgical methods coexist without any real evidence for the superiority of one or the other. The volar anatomy of the wrist offers a good option to use the space between the volar cortex and the flexor tendons for internal fixation with an angle fixed bar plating system (ITS). This study shows, in a representative number of cases, that palmar plating of unstable fractures of the distal radius is as well in young and elderly patients a safe and effective treatment modality.