Artikel
Relationship between width of volar locking plate and loss of reduction in distal radius fracture
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Autoren
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Masashi Isaji
- JSDF Central Hospital, Orthopaedics, Tokyo Setagaya, Japan
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Masatoshi Amako
- National Defense Medical College, Department of Orthopaedic Surgery, Saitama Tokorozawa, Japan
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Ryoji Fujimaki
- National Defense Medical College, Department of Orthopaedic Surgery, Saitama Tokorozawa, Japan
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Mao Yamada
- National Defense Medical College, Department of Orthopaedic Surgery, Saitama Tokorozawa, Japan
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Kazuhiro Chiba
- National Defense Medical College, Department of Orthopaedic Surgery, Saitama Tokorozawa, Japan
| Veröffentlicht: | 6. Februar 2020 |
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Gliederung
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Objectives/Interrogation: Volar locked plating (VLP) is a standard procedure for distal radius fracture (DRF). The width of locking plate is usually decided in accordance with the width of the distal radius, however, the optimal width of the plate is not well known. The purpose of this study was to disclose relationship between the width of the plate and loss of reduction after VLP fixation.
Methods: Forty-three patients with DRF were treated using VLP between 2014 and 2017. There were 28 females and 15 males, with an average age of 62.4 years. The average follow-up period was 8.1 months. According to AO classification, there were 7 type A, 2 type B, and 34 type C. The maximum width of the plate and the distal radius were measured on the radiological frontal view, and the radio-plate ratio were calculated. We also evaluated loss of reduction by changes in three radiological parameters, radial inclination, palmar tilt, and ulnar variance from immediate after surgery to the final follow-up. Correlation coefficient between the radio-plate ratio and loss of reduction were evaluated. We also divided patients into two groups according to the radio-plate ratio: the wider group (more than 0.65), and the narrower group (less than 0.65), and compared loss of reduction and postoperative complications.
Results and Conclusions: The radio-plate ratio were distributed between 0.56 and 0.85, with an average of 0.72. There were no significant correlations between the radio-plate ratio and the three radiological parameters. There were no significant difference in three parameters between two groups. Although, the narrower group had no complication, one patient with tendinitis of the flexor pollicis longus was observed in the wider group.
DRF is usually treated with a wider plate, and all comminuted fragments are fixed by locking screws, however there was no difference in loss of reduction between those treated with wider and narrower plates. Because we experienced one case of flexor tendinitis in patients treated with a wider plate, we believe that most DRFs could be fixed sufficiently with a narrower plate, and with less complications.
