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Erschienen in:
01.06.2010 | Trauma Surgery
Clinical and radiological outcomes after stabilisation of complex intra-articular fractures of the distal radius with the volar 2.4 mm LCP
Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 6/2010
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Aim
The purpose of the present study is to evaluate the results of the treatment of intra-articular fractures with the volar 2.4 mm LCP with regard to loss of reduction, clinical outcome and complications.
Patients
Patients treated with a volar 2.4 mm LCP following a complex intra-articular distal radius fracture were assessed by clinical and radiological examination of both wrists, the Disability of Arm, Shoulder and Hand (DASH) outcome instrument, Martini score and the pain Visual Analogue Scale score. Forty patients (40 fractures: 5 type C1, 11 type C2, and 24 type C3 according to AO/OTA classification) were followed at a mean 18 months from the injury.
Results
Of the initial 40 fractures, 4 fractures required surgical revision (1 because of loss of reduction, 2 due to fracture incongruity as seen on the postoperative computer tomogram and 1 case of screw displacement in the radial shaft). Radiographs in the immediate postoperative period showed a radial inclination of 22.1°, volar tilt of 7.2°, and ulnar deviation of 0.2 mm (means). At follow-up examination, radial inclination was 23.8°, volar tilt was 6.2° and ulnar deviation was 0.9 mm (means). Average final wrist range of motion was significantly (p < 0.05) decreased in comparison to contralateral wrist. Average DASH and Martini scores were 18 and 27, respectively, with no significant differences between C1-, C2- and C3-type fractures. Patients who underwent a surgical revision had poorer Martini score. Complications were an EPL tendon rupture, a tendon irritation and a complex regional pain syndrome in a patient who underwent revision.
Conclusion
The treatment of complex intra-articular distal radius fractures with the volar 2.4 mm LCP provides sufficient fixation to prevent clinically significant loss of articular reduction, acceptable patient outcomes and minimal soft tissue complications.