Restoration of Radiological Parameters with Fragment Specific Fixation for Distal Radius Fractures: A Case Series
Keywords:
Distal Radius; Fragment-specific, Radiological outcomes.Abstract
Objective: To assess the radiological outcomes of fragment-specific fixation for complex distal radius fractures.
Methods: We conducted a retrospective case series of patients presenting with complex distal radius fractures and undergoing fragment-specific fixation between 1st January 2018 and 31st December 2019. Demographic information and mechanism of injury were recorded. Pre- and post-operative radiographs were analysed for fracture type, radial height, radial inclination, and palmar tilt.
Results: A total of 15 patients were included in the study with a mean age of 40 ± 10 years. Most common mechanism of injury was RTA (67%) followed by fall. The most common fracture was noted to be AO type C3.1t (33%). A significant improvement in radial height and radial inclination was noted post-operatively (P-values = 0.014 and 0.038 respectively). Mean palmar tilt improved from 0.44° ± 17.5° preoperatively to 7.11° ± 6.64° post-operatively.
Conclusion: Fragment-specific fixation is an effective treatment option for complex distal radius fractures with the ability to restore normal radiological parameters after surgery.
References
Nellans KW, Kowalski E, Chung KC. The epidemiology of distal radius fractures. Hand clinics. 2012;28(2):113-25.
Flinkkilä T, Sirniö K, Hippi M, Hartonen S, Ruuhela R, Ohtonen P, et al. Epidemiology and seasonal variation of distal radius fractures in Oulu, Finland. Osteoporosis international. 2011;22(8):2307-12.
Babikir EME, Al-Maqdassy ED, Hasan K, Hameed SA, Alhammoud A, Al-Dosari MMA-A. Efficiency of fragment specific fixation plates in the treatment of comminuted distal radial fractures. International orthopaedics. 2017;41(9):1763-9.
Hozack BA, Tosti RJ. Fragment-Specific Fixation in Distal Radius Fractures. Current reviews in musculoskeletal medicine. 2019;12(2):190-7.
Müller ME, Nazarian S, Koch P, Schatzker J. The comprehensive classification of fractures of long bones: Springer Science & Business Media; 2012.
Nesbitt KS, Failla JM, Les C. Assessment of instability factors in adult distal radius fractures. The Journal of hand surgery. 2004;29(6):1128-38.
Rizzo M, Katt BA, Carothers JT. Comparison of locked volar plating versus pinning and external fixation in the treatment of unstable intraarticular distal radius fractures. Hand. 2008;3(2):111-7.
Schneeberger AG, Ip WY, Poon TL, Chow SP. Open reduction and plate fixation of displaced AO type C3 fractures of the distal radius: restoration of articular congruity in eighteen cases. Journal of orthopaedic trauma. 2001;15(5):350-7.
Schumer ED, Leslie BM. Fragment-specific fixation of distal radius fractures using the Trimed device. Techniques in hand & upper extremity surgery. 2005;9(2):74-83.
Taylor KF, Parks BG, Segalman KA. Biomechanical stability of a fixed-angle volar plate versus fragment-specific fixation system: cyclic testing in a C2-type distal radius cadaver fracture model. The Journal of hand surgery. 2006;31(3):373-81.
Geissler WB, Clark SM. Fragment-specific fixation for fractures of the distal radius. Journal of wrist surgery. 2016;5(01):022-30.
Geissler WB. Management distal radius and distal ulnar fractures with fragment specific plate. Journal of wrist surgery. 2013;2(02):190-4.
Fernandez DL, Geissler WB. Treatment of displaced articular fractures of the radius. The Journal of hand surgery. 1991;16(3):375-84.
Konrath GA, Bahler S. Open reduction and internal fixation of unstable distal radius fractures: results using the trimed fixation system. Journal of orthopaedic trauma. 2002;16(8):578-85.
Sammer DM, Fuller DS, Kim MH, Chung KC. A comparative study of fragment specific versus volar plate fixation of distal radius fractures. Plast Reconstr Surg. 2008;122(5):1441.
Schneppendahl J, Windolf J, Kaufmann RA. Distal radius fractures: current concepts. The Journal of hand surgery. 2012;37(8):1718-25.
Lam J, Wolfe SW. Distal radius fractures: what cannot be fixed with a volar plate?—the role of fragment-specific fixation in modern fracture treatment. Operative Techniques in Sports Medicine. 2010;18(3):181-8.