BibTex RIS Kaynak Göster

The outcomes of volar locking plating for intraarticular distal radius fractures

Yıl 2014, Cilt: 41 Sayı: 2, 282 - 287, 01.06.2014
https://doi.org/10.5798/diclemedj.0921.2014.02.0417

Öz

Objective: We aimed to evaluate the functional and radiological results of intraarticular distal radius fractures which treated with volar locking plates. Methods: Twenty-eight patient (mean age 44.6; range 19-74) with intraarticular distal radius fracture were treated with volar locking plate. Of these 18 were type B, and 10 were type C. Mean follow-up was 19 months. Patients were evaluated with MAYO score, and DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire. Shortening, radial inclination and palmar tilt were recorded. Uninjured wrist was used for comparison. Results: Union was achieved in all fractures. MAYO score revealed excellent results in 6 patients, good in 7 patients, satisfactory in 14 patients, and poor in 1 patients at the latest follow-up. The mean postoperative DASH score was 16.4 (range, 0-76). The mean radial inclination loss was 0.9 degrees and mean palmar tilt loss was 6.9 degrees when compared to uninjured wrist. Active flexion was 56.3°, extension was 52.5°, supination was 74.2° and pronation was 70.7°. Extensor tenosynovitis was observed in four patients, fleksor pollisis longus tenosynovitis in two, carpal tunnel syndrome in two, superficial infection in one, sudeck atrophy in one. Conclusion: Volar locking plates maintain adequate stability with satisfactory functional results in the treatment of intraarticular distal radius fractures. However, flexor and extensor tendon problems, entrapment of median nerve and reflex sympathetic dystrophy should be kept in mind which might be encountered. In case of tenosynivitis, if union had been achieved the implants should be removed without delay.

Kaynakça

  • Sügün TS, Gürbüz Y, Özaksar K, et al. İnstabil distal radius kırıklarında volar kilitli plakla tespit sonuçları. Acta Orthop Traumatol Turc 2012;46:22-25.
  • Orbay JL, Fernandez DL. Volar fixation for dorsally dis- placed fractures of the distal radius: a preliminary report. J Hand Surg Am 2002;27:205-215.
  • Smith DW, Henry MH. Volar fixed-angle plating of the distal radius. J Am Acad Orthop Surg 2005;13:28-36.
  • Kitay A, Swanstrom M, Schreiber JJ, at al. Volar plate posi- tion and flexor tendon rupture following distal radius frac- ture fixation. J Hand Surg Am 2013;38:1091-1096.
  • Arora R, Lutz M, Hennerbichler A, et al. Complications fol- lowing internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma 2007;21:316- 322.
  • Chilelli BJ, Patel RM, Kalainov DM, et al. Flexor pollicis longus dysfunction after volar plate fixation of distal radius fractures. J Hand Surg Am 2013;38:1691-1697.
  • Rhee SH, Kim J, Lee YH, et al. Factors affecting late dis- placement following volar locking plate fixation for distal radial fractures in elderly female patients. Bone Joint J 2013;95:396-400.
  • Rozental TD, Blazar PE. Functional outcome and compli- cations after volar plating for dorsally displaced, unstable fractures of the distal radius. J Hand Surg Am 2006;31:359- 365.
  • Yu YR, Makhni MC, Tabrizi S, et al. Complications of low- profile dorsal versus volar locking plates in the distal radius: a comparative study. J Hand Surg Am. 2011;36:1135-1141.
  • Mueller ME, Nazarian S, Koch P, et al. The comprehensive classification of fractures of long bones. Berlin, Germany: Springer-Verlag; 1990:100-101.
  • Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones. retrospective and prospective analyses. J Bone Joint Surg Am. 1976;58:453-458.
  • Knirk JL, Jupiter JB. Intra-articular fractures of the distal end of the radius in young adults. J Bone Joint Surg [Am] 1986;68:647-659.
  • Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabili- ties of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med 1996;29:602-608.
  • Amadio PC, Berquist TH, Smith DK, et al. Scaphoid mal- union. J Hand Surg Am 1989;14:679-687.
  • K István, S János, R Antal, et al. A new technique for dis- tal forearm fractures: the external radius fixator. Eklem Hastalık Cerrahisi 2007;18:143-149.
  • Vural Ö, Okçu G, RT Özalp, et al. Closed reduction and casting versus Kapandji technique for the treatment of Col- les fractures: a prospective, randomized clinical trial. Ekl- em Hastalık Cerrahisi 2008;19:55-60.
  • Lattmann T, Meier C, Dietrich M, et al. Results of volar locking plate osteosynthesis for distal radial fractures. J Trauma 2011;70:1510-1518.
  • Musgrave DS, Idler RS. Volar fixation of dorsally displaced distal radius fractures using the 2.4-mm locking compres- sion plates. J Hand Surg Am 2005;30:743-749.
  • Jupiter JB, Marent-Huber M; LCP Study Group. Operative management of distal radial fractures with 2.4-millimeter locking plates. A multicenter prospective case series. J Bone Joint Surg Am 2009;91:55-65.
  • Kiliç A, Kabukçuoğlu Y, Ozkaya U, et al. Volar locking plate fixation of unstable distal radius fractures. Acta Or- thop Traumatol Turc 2009;43:303-308.
  • Functional results and complications following locking palmar plating on the distal radius: a retrospective study. J Hand Surg Eur Vol 2010;35:283-288.
  • von Recum J, Matschke S, Jupiter JB, et al. Characteristics of two different locking compression plates in the volar fix- ation of complex articular distalradius fractures. Bone Joint Res 2012;1:111-117.
  • Drobetz H, Kutscha-Lissberg E. Osteosynthesis of distal radial fractures with a volar locking screw plate system. Int Orthop 2003;27:1-6.
  • Cho CH, Lee KJ, Song KS, Bae KC. Delayed rupture of flexor pollicis longus after volar plating for a distal radius fracture. Clin Orthop Surg 2012;4:325-328.
  • Cross AW, Schmidt CC. Flexor tendon injuries following locked volar plating of distal radius fractures. J Hand Surg Am 2008;33:164-167.
  • Bell JS, Wollstein R, Citron ND. Rupture of flexor pollicis longus tendon: A complication of volar plating of the distal radius. J Bone Joint Surg Br. 1998;80:225-226.

Eklem içi distal radius kırıklarının volar kilitli plakla tedavi sonuçları

Yıl 2014, Cilt: 41 Sayı: 2, 282 - 287, 01.06.2014
https://doi.org/10.5798/diclemedj.0921.2014.02.0417

Öz

Amaç: Çalışmamızda eklem içi distal radius kırıklarında volar kilitli plakla tespitin fonksiyonel ve radyolojik sonuçlarının değerlendirilmesi amaçlandı. Yöntemler: Eklem içi distal radius kırığı tanısıyla volar kilitli plakla tedavi edilen 28 hasta (ort. yaş 44.6; dağılım 19-74) çalışmaya alındı. Kırıklar AO/ASIF sınıflamasına göre sınıflandırıldı. Buna göre 18 hasta B ve 10 hasta C tipi kırık idi. Ortalama takip süresi 19 ay (dağılım 12-28) idi. Hastalar MAYO el bileği skoru ve DASH (Disabilities of the Arm, Shoulder and Hand) anketi ile değerlendirildi. Radyolojik incelemede radial kısalma, radial ve palmar eğimler ölçüldü. Klinik ve radyolojik karşılaştırma için sağlam el bileği kullanıldı. Bulgular: Tüm kırıklarda kaynama elde edildi. Ameliyat sonrası MAYO skorlamasında 6 hastada mükemmel, 7 hastada iyi, 14 hastada yeterli ve bir hastada kötü sonuç alındı. Ortalama DASH skoru 16.4 (dağılım 0-76) olarak bulundu. Sağlam tarafla karşılaştırıldığında radial eğimde ortalama 0.9 derecelik ve palmar eğimde ortalama 6.9 derecelik kayıp saptandı. Ortalama aktif fleksiyon 56.3°, ekstansiyon 52.5°, supinasyon 74.2° ve pronasyon 70.7° ölçüldü. Dört hastada ekstansör tendon tenosinoviti, iki hastada fleksör pollisis longus tenosinoviti, iki hastada karpal tünel sendromu, bir hastada yüzeyel enfeksiyon ve bir hastada refleks sempatik distrofi görüldü. Sonuçlar: Volar kilitli plaklar, eklem içi distal radius kırıklarının tedavisinde yeterli tespit ve tatmin edici fonksiyonel sonuçlar sağlamaktadır. Bununla birlikte, fleksör ve ekstansör tendon sorunları, median sinir tuzaklanması ve refleks sempatik distrofi ile karşılaşılabileceği akılda tutulmalıdır. Tenosinovit semptomlarının gözlendiği olgularda, kaynama sağlanmışsa vakit kaybetmeksizin implantlar çıkarılmalıdır.

Kaynakça

  • Sügün TS, Gürbüz Y, Özaksar K, et al. İnstabil distal radius kırıklarında volar kilitli plakla tespit sonuçları. Acta Orthop Traumatol Turc 2012;46:22-25.
  • Orbay JL, Fernandez DL. Volar fixation for dorsally dis- placed fractures of the distal radius: a preliminary report. J Hand Surg Am 2002;27:205-215.
  • Smith DW, Henry MH. Volar fixed-angle plating of the distal radius. J Am Acad Orthop Surg 2005;13:28-36.
  • Kitay A, Swanstrom M, Schreiber JJ, at al. Volar plate posi- tion and flexor tendon rupture following distal radius frac- ture fixation. J Hand Surg Am 2013;38:1091-1096.
  • Arora R, Lutz M, Hennerbichler A, et al. Complications fol- lowing internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma 2007;21:316- 322.
  • Chilelli BJ, Patel RM, Kalainov DM, et al. Flexor pollicis longus dysfunction after volar plate fixation of distal radius fractures. J Hand Surg Am 2013;38:1691-1697.
  • Rhee SH, Kim J, Lee YH, et al. Factors affecting late dis- placement following volar locking plate fixation for distal radial fractures in elderly female patients. Bone Joint J 2013;95:396-400.
  • Rozental TD, Blazar PE. Functional outcome and compli- cations after volar plating for dorsally displaced, unstable fractures of the distal radius. J Hand Surg Am 2006;31:359- 365.
  • Yu YR, Makhni MC, Tabrizi S, et al. Complications of low- profile dorsal versus volar locking plates in the distal radius: a comparative study. J Hand Surg Am. 2011;36:1135-1141.
  • Mueller ME, Nazarian S, Koch P, et al. The comprehensive classification of fractures of long bones. Berlin, Germany: Springer-Verlag; 1990:100-101.
  • Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones. retrospective and prospective analyses. J Bone Joint Surg Am. 1976;58:453-458.
  • Knirk JL, Jupiter JB. Intra-articular fractures of the distal end of the radius in young adults. J Bone Joint Surg [Am] 1986;68:647-659.
  • Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabili- ties of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med 1996;29:602-608.
  • Amadio PC, Berquist TH, Smith DK, et al. Scaphoid mal- union. J Hand Surg Am 1989;14:679-687.
  • K István, S János, R Antal, et al. A new technique for dis- tal forearm fractures: the external radius fixator. Eklem Hastalık Cerrahisi 2007;18:143-149.
  • Vural Ö, Okçu G, RT Özalp, et al. Closed reduction and casting versus Kapandji technique for the treatment of Col- les fractures: a prospective, randomized clinical trial. Ekl- em Hastalık Cerrahisi 2008;19:55-60.
  • Lattmann T, Meier C, Dietrich M, et al. Results of volar locking plate osteosynthesis for distal radial fractures. J Trauma 2011;70:1510-1518.
  • Musgrave DS, Idler RS. Volar fixation of dorsally displaced distal radius fractures using the 2.4-mm locking compres- sion plates. J Hand Surg Am 2005;30:743-749.
  • Jupiter JB, Marent-Huber M; LCP Study Group. Operative management of distal radial fractures with 2.4-millimeter locking plates. A multicenter prospective case series. J Bone Joint Surg Am 2009;91:55-65.
  • Kiliç A, Kabukçuoğlu Y, Ozkaya U, et al. Volar locking plate fixation of unstable distal radius fractures. Acta Or- thop Traumatol Turc 2009;43:303-308.
  • Functional results and complications following locking palmar plating on the distal radius: a retrospective study. J Hand Surg Eur Vol 2010;35:283-288.
  • von Recum J, Matschke S, Jupiter JB, et al. Characteristics of two different locking compression plates in the volar fix- ation of complex articular distalradius fractures. Bone Joint Res 2012;1:111-117.
  • Drobetz H, Kutscha-Lissberg E. Osteosynthesis of distal radial fractures with a volar locking screw plate system. Int Orthop 2003;27:1-6.
  • Cho CH, Lee KJ, Song KS, Bae KC. Delayed rupture of flexor pollicis longus after volar plating for a distal radius fracture. Clin Orthop Surg 2012;4:325-328.
  • Cross AW, Schmidt CC. Flexor tendon injuries following locked volar plating of distal radius fractures. J Hand Surg Am 2008;33:164-167.
  • Bell JS, Wollstein R, Citron ND. Rupture of flexor pollicis longus tendon: A complication of volar plating of the distal radius. J Bone Joint Surg Br. 1998;80:225-226.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Yazıları
Yazarlar

İbrahim Azboy Bu kişi benim

Abdullah Demirtaş Bu kişi benim

Celil Alemdar Bu kişi benim

Sinan Zehir Bu kişi benim

İdris Ahmet Çakır Bu kişi benim

İlhami Şahin Bu kişi benim

Yayımlanma Tarihi 1 Haziran 2014
Gönderilme Tarihi 2 Mart 2015
Yayımlandığı Sayı Yıl 2014 Cilt: 41 Sayı: 2

Kaynak Göster

APA Azboy, İ., Demirtaş, A., Alemdar, C., Zehir, S., vd. (2014). Eklem içi distal radius kırıklarının volar kilitli plakla tedavi sonuçları. Dicle Tıp Dergisi, 41(2), 282-287. https://doi.org/10.5798/diclemedj.0921.2014.02.0417
AMA Azboy İ, Demirtaş A, Alemdar C, Zehir S, Çakır İA, Şahin İ. Eklem içi distal radius kırıklarının volar kilitli plakla tedavi sonuçları. diclemedj. Haziran 2014;41(2):282-287. doi:10.5798/diclemedj.0921.2014.02.0417
Chicago Azboy, İbrahim, Abdullah Demirtaş, Celil Alemdar, Sinan Zehir, İdris Ahmet Çakır, ve İlhami Şahin. “Eklem içi Distal Radius kırıklarının Volar Kilitli Plakla Tedavi sonuçları”. Dicle Tıp Dergisi 41, sy. 2 (Haziran 2014): 282-87. https://doi.org/10.5798/diclemedj.0921.2014.02.0417.
EndNote Azboy İ, Demirtaş A, Alemdar C, Zehir S, Çakır İA, Şahin İ (01 Haziran 2014) Eklem içi distal radius kırıklarının volar kilitli plakla tedavi sonuçları. Dicle Tıp Dergisi 41 2 282–287.
IEEE İ. Azboy, A. Demirtaş, C. Alemdar, S. Zehir, İ. A. Çakır, ve İ. Şahin, “Eklem içi distal radius kırıklarının volar kilitli plakla tedavi sonuçları”, diclemedj, c. 41, sy. 2, ss. 282–287, 2014, doi: 10.5798/diclemedj.0921.2014.02.0417.
ISNAD Azboy, İbrahim vd. “Eklem içi Distal Radius kırıklarının Volar Kilitli Plakla Tedavi sonuçları”. Dicle Tıp Dergisi 41/2 (Haziran 2014), 282-287. https://doi.org/10.5798/diclemedj.0921.2014.02.0417.
JAMA Azboy İ, Demirtaş A, Alemdar C, Zehir S, Çakır İA, Şahin İ. Eklem içi distal radius kırıklarının volar kilitli plakla tedavi sonuçları. diclemedj. 2014;41:282–287.
MLA Azboy, İbrahim vd. “Eklem içi Distal Radius kırıklarının Volar Kilitli Plakla Tedavi sonuçları”. Dicle Tıp Dergisi, c. 41, sy. 2, 2014, ss. 282-7, doi:10.5798/diclemedj.0921.2014.02.0417.
Vancouver Azboy İ, Demirtaş A, Alemdar C, Zehir S, Çakır İA, Şahin İ. Eklem içi distal radius kırıklarının volar kilitli plakla tedavi sonuçları. diclemedj. 2014;41(2):282-7.