Functional and radiological comparison of volar locking plate and K-wire augmented volar locking plate fixation in intra-articular and comminuted distal radius fractures

Yıl 2024, Cilt: 8 Sayı: 3, 181 - 188, 30.12.2024

Cem Yildirim , Mehmet Ekinci , Şahan Dağlar , Osman Görkem Muratoğlu , Hüseyin Öztürk , Okyar Altaş

https://doi.org/10.30565/medalanya.1504653

Öz

Aim: This study aims to determine whether additional K-wires to volar plating impact the radiologic and functional outcomes of comminuted distal radius fractures (DRFs).

Methods: Forty-two patients treated with either a volar locking plate or a K-wire augmented volar locking plate for intra-articular comminuted distal radius fractures (AO type C) between February 2008 and December 2014 at Haseki Hospital were retrospectively analyzed. Wrist range of motion and hand grip strength were recorded. Patients were evaluated using the Gartland-Werley scale, QuickDASH scale, and Mayo wrist score. Radiological assessments were based on wrist radiographs taken during the last follow-up.

Results: No statistically significant difference was observed between the two groups in terms of the range of motion of the affected wrist joint (all p values >0.05). Similarly, there were no statistically significant differences in the Mayo wrist score, Gartland-Werley score, QuickDASH scale, or Stewart score between the two groups (p=0.17, p=0.36, p=0.38, and p=0.35, respectively). At final follow-ups, radial length loss and radial tilt loss did not significantly differ in either group compared to the healthy side (p=0.98 and p=0.96, respectively).

Conclusion: Given the potential complications associated with bridge external fixators and K-wires in treating comminuted distal radius fractures, volar locking plates can be safely used alone for managing these fractures.

Anahtar Kelimeler

Intra-articular distal radius fracture, K wire augmented locking plate, functional outcomes, wrist injuries

Eklem içi ve parçalı distal radius kırıklarında volar kilitli plak ile K-teli destekli volar kilitli plak tespitinin fonksiyonel ve radyolojik karşılaştırması

Öz

Amaç: Bu çalışmanın amacı, volar plaklamaya eklenen K-tellerinin parçalı distal radius kırıklarının radyolojik ve fonksiyonel sonuçlarını etkileyip etkilemediğini belirlemektir.

Gereç ve Yöntem: Şubat 2008 ile Aralık 2014 tarihleri arasında Haseki Hastanesi’nde eklem içi parçalı distal radius kırıkları (AO tip C) nedeniyle volar kilitli plak veya K-teli destekli volar kilitli plak ile tedavi edilen 42 hasta retrospektif olarak incelenmiştir. Bilek hareket açıklığı ve el kavrama kuvvetleri kaydedilmiştir. Hastalar, Gartland-Werley skalası, QuickDASH ölçeği ve Mayo bilek skoru kullanılarak değerlendirilmiştir. Radyolojik değerlendirmeler, son kontrolde çekilen bilek grafileri ile yapılmıştır.

Bulgular: Etkilenen bilek ekleminin hareket açıklığında iki grup arasında istatistiksel olarak anlamlı bir fark saptanmamıştır (tüm p değerleri >0,05). Aynı şekilde, Mayo bilek skoru, Gartland-Werley skoru, QuickDASH ölçeği ve Stewart skoru açısından da istatistiksel olarak anlamlı bir fark gözlenmemiştir (sırasıyla p=0,17, p=0,36, p=0,38 ve p=0,35). Son kontrollerde radial uzunluk kaybı ve radial tilt kaybı her iki grupta sağlıklı tarafa göre anlamlı farklılık göstermemiştir (sırasıyla p=0,98 ve p=0,96).

Sonuç: Eklem içi parçalı distal radius kırıkları tedavisinde köprü eksternal fiksatörler ve K-tellerinin olası komplikasyonları göz önünde bulundurulduğunda, bu kırıkların tedavisinde volar kilitli plakların tek başına güvenle kullanılabileceği sonucuna varılmıştır.

Anahtar Kelimeler

Eklem içi distal radius kırığı; K-teli destekli kilitli plaklama; fonksiyonel sonuçlar; el bilek yaralanmaları

Kaynakça

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