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Erschienen in: European Journal of Trauma and Emergency Surgery 3/2020

27.02.2019 | Original Article

Comparison of fracture healing and long-term patient-reported functional outcome between dorsal and volar plating for AO C3-type distal radius fractures

verfasst von: Paphon Sa-ngasoongsong, Manuela Rohner-Spengler, Dimitri E. Delagrammaticas, Reto Hansjörg Babst, Frank J. P. Beeres

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 3/2020

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Abstract

Purpose

This study aimed to evaluate the differences in long-term functional outcome and radiographic fracture healing between volar and dorsally approached comminuted intra-articular distal radius fractures (DRF) (AO C3-type).

Methods

A retrospective, age-matched, case–control study with a 1:2 allocation ratio was conducted in 84 patients C3-type DRFs patients who underwent either dorsal locking plating (DLP) group (n = 28) or volar locking plating (VLP) group (n = 56). Standardized wrist radiographs (posterior–anterior and 15° lateral) were assessed immediately postoperative and at final follow. To evaluate for loss of reduction standard radiographic measurements were performed. Fracture healing was assessed radiologically. Patient-reported outcomes were assessed with the patient-related wrist evaluation and the EQ-5D-3L for health-related quality of life. Patient satisfaction was assessed with the use of a numeric analog scale ranging from 0 (not satisfied) to 100 (very satisfied).

Results

All fractures united within 3 months postoperatively. Average age was 59 ± 12 years. Fifty-five patients (66%) participated in the follow-up survey at an average of 76.6 ± 23.8 months. DLP group showed a significant change in sagittal tilt compared with VLP group (3.4 ± 3.0° vs − 0.4 ± 4.1°, p < 0.001). No significant difference in other radiographic and long-term functional outcome was found between both groups (p > 0.05).

Conclusion

Dorsal locking plating fixation in C3-type DRFs resulted in a minimal, but statistically significant, volar collapse of sagittal tilt compared with volar locking plating fixation. However, this difference in volar collapse did not significantly influence the long-term clinical outcome.
Literatur
1.
Zurück zum Zitat Letsch R, Infanger M, Schmidt J, Kock HJ. Surgical treatment of fractures of the distal radius with plates: a comparison of palmar and dorsal plate position. Arch Orthop Trauma Surg. 2003;123(7):333–9.CrossRef Letsch R, Infanger M, Schmidt J, Kock HJ. Surgical treatment of fractures of the distal radius with plates: a comparison of palmar and dorsal plate position. Arch Orthop Trauma Surg. 2003;123(7):333–9.CrossRef
2.
Zurück zum Zitat Elsaidi GA, Deal N, Smith BP, Ruch DS. Volar collapse after dorsal plating of comminuted distal radius fractures. Am J Orthop (Belle Mead, NJ). 2007;36(5):269–72. Elsaidi GA, Deal N, Smith BP, Ruch DS. Volar collapse after dorsal plating of comminuted distal radius fractures. Am J Orthop (Belle Mead, NJ). 2007;36(5):269–72.
3.
Zurück zum Zitat Jakubietz MG, Gruenert JG, Jakubietz RG. Palmar and dorsal fixed-angle plates in AO C-type fractures of the distal radius: is there an advantage of palmar plates in the long term? J Orthop Surg Res. 2012;7(1):8.CrossRef Jakubietz MG, Gruenert JG, Jakubietz RG. Palmar and dorsal fixed-angle plates in AO C-type fractures of the distal radius: is there an advantage of palmar plates in the long term? J Orthop Surg Res. 2012;7(1):8.CrossRef
4.
Zurück zum Zitat Ruch DS, Papadonikolakis A. Volar versus dorsal plating in the management of intra-articular distal radius fractures. J Hand Surg. 2006;31(1):9–16.CrossRef Ruch DS, Papadonikolakis A. Volar versus dorsal plating in the management of intra-articular distal radius fractures. J Hand Surg. 2006;31(1):9–16.CrossRef
5.
Zurück zum Zitat Jakubietz RG, Gruenert JG, Kloss DF, Schindele S, Jakubietz MG. A randomised clinical study comparing palmar and dorsal fixed-angle plates for the internal fixation of AO C-type fractures of the distal radius in the elderly. J Hand Surg Eur. 2008;33(5):600–4.CrossRef Jakubietz RG, Gruenert JG, Kloss DF, Schindele S, Jakubietz MG. A randomised clinical study comparing palmar and dorsal fixed-angle plates for the internal fixation of AO C-type fractures of the distal radius in the elderly. J Hand Surg Eur. 2008;33(5):600–4.CrossRef
6.
Zurück zum Zitat Rein S, Schikore H, Schneiders W, Amlang M, Zwipp H. Results of dorsal or volar plate fixation of AO type C3 distal radius fractures: a retrospective study. J Hand Surg. 2007;32(7):954–61.CrossRef Rein S, Schikore H, Schneiders W, Amlang M, Zwipp H. Results of dorsal or volar plate fixation of AO type C3 distal radius fractures: a retrospective study. J Hand Surg. 2007;32(7):954–61.CrossRef
7.
Zurück zum Zitat Chou YC, Chen AC, Chen CY, Hsu YH, Wu CC. Dorsal and volar 2.4-mm titanium locking plate fixation for AO type C3 dorsally comminuted distal radius fractures. J Hand Surg. 2011;36(6):974–81.CrossRef Chou YC, Chen AC, Chen CY, Hsu YH, Wu CC. Dorsal and volar 2.4-mm titanium locking plate fixation for AO type C3 dorsally comminuted distal radius fractures. J Hand Surg. 2011;36(6):974–81.CrossRef
8.
Zurück zum Zitat Rikli DA, Businger A, Babst R. Dorsal double-plate fixation of the distal radius. Oper Orthop Traumatol. 2005;17(6):624–40 (Epub 2005/12/22.Engger).CrossRef Rikli DA, Businger A, Babst R. Dorsal double-plate fixation of the distal radius. Oper Orthop Traumatol. 2005;17(6):624–40 (Epub 2005/12/22.Engger).CrossRef
9.
Zurück zum Zitat Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, et al. Fracture and dislocation classification compendium—2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma. 2007;21(10 Suppl):S1–133.CrossRef Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, et al. Fracture and dislocation classification compendium—2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma. 2007;21(10 Suppl):S1–133.CrossRef
10.
Zurück zum Zitat Kreder HJ, Hanel DP, McKee M, Jupiter J, McGillivary G, Swiontkowski MF. X-ray film measurements for healed distal radius fractures. J Hand Surg. 1996;21(1):31–9.CrossRef Kreder HJ, Hanel DP, McKee M, Jupiter J, McGillivary G, Swiontkowski MF. X-ray film measurements for healed distal radius fractures. J Hand Surg. 1996;21(1):31–9.CrossRef
11.
Zurück zum Zitat Medoff RJ. Essential radiographic evaluation for distal radius fractures. Hand Clin. 2005;21(3):279–88.CrossRef Medoff RJ. Essential radiographic evaluation for distal radius fractures. Hand Clin. 2005;21(3):279–88.CrossRef
12.
Zurück zum Zitat Nattrass GR, King GJ, McMurtry RY, Brant RF. An alternative method for determination of the carpal height ratio. J Bone Jt Surg Am. 1994;76(1):88–94.CrossRef Nattrass GR, King GJ, McMurtry RY, Brant RF. An alternative method for determination of the carpal height ratio. J Bone Jt Surg Am. 1994;76(1):88–94.CrossRef
13.
Zurück zum Zitat de Vries J, Souer JS, Zurakowski D, Ring D. Measurement of ulnar variance on uncalibrated digital radiographic images. Hand. 2010;5(3):267–72.CrossRef de Vries J, Souer JS, Zurakowski D, Ring D. Measurement of ulnar variance on uncalibrated digital radiographic images. Hand. 2010;5(3):267–72.CrossRef
14.
Zurück zum Zitat Knirk JL, Jupiter JB. Intra-articular fractures of the distal end of the radius in young adults. J Bone Joint Surg Am. 1986;68(5):647–59.CrossRef Knirk JL, Jupiter JB. Intra-articular fractures of the distal end of the radius in young adults. J Bone Joint Surg Am. 1986;68(5):647–59.CrossRef
15.
Zurück zum Zitat Harden RN, Bruehl S, Stanton-Hicks M, Wilson PR. Proposed new diagnostic criteria for complex regional pain syndrome. Pain Med. 2007;8(4):326–31.CrossRef Harden RN, Bruehl S, Stanton-Hicks M, Wilson PR. Proposed new diagnostic criteria for complex regional pain syndrome. Pain Med. 2007;8(4):326–31.CrossRef
16.
Zurück zum Zitat MacDermid JC, Turgeon T, Richards RS, Beadle M, Roth JH. Patient rating of wrist pain and disability: a reliable and valid measurement tool. J Orthop Trauma. 1998;12(8):577–86.CrossRef MacDermid JC, Turgeon T, Richards RS, Beadle M, Roth JH. Patient rating of wrist pain and disability: a reliable and valid measurement tool. J Orthop Trauma. 1998;12(8):577–86.CrossRef
17.
Zurück zum Zitat EuroQol G. EuroQol—a new facility for the measurement of health-related quality of life. Health Policy. 1990;16(3):199–208.CrossRef EuroQol G. EuroQol—a new facility for the measurement of health-related quality of life. Health Policy. 1990;16(3):199–208.CrossRef
18.
Zurück zum Zitat Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155–63.CrossRef Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155–63.CrossRef
19.
Zurück zum Zitat Wichlas F, Haas NP, Disch A, Macho D, Tsitsilonis S. Complication rates and reduction potential of palmar versus dorsal locking plate osteosynthesis for the treatment of distal radius fractures. J Orthop Traumatol. 2014;15(4):259–64.CrossRef Wichlas F, Haas NP, Disch A, Macho D, Tsitsilonis S. Complication rates and reduction potential of palmar versus dorsal locking plate osteosynthesis for the treatment of distal radius fractures. J Orthop Traumatol. 2014;15(4):259–64.CrossRef
20.
Zurück zum Zitat Disseldorp DJ, Hannemann PF, Poeze M, Brink PR. Dorsal or volar plate fixation of the distal radius: does the complication rate help us to choose? J Wrist Surg. 2016;5(3):202–10.CrossRef Disseldorp DJ, Hannemann PF, Poeze M, Brink PR. Dorsal or volar plate fixation of the distal radius: does the complication rate help us to choose? J Wrist Surg. 2016;5(3):202–10.CrossRef
21.
Zurück zum Zitat Rose S, Laan MJ. Why match? Investigating matched case–control study designs with causal effect estimation. Int J Biostat. 2009;5(1):Article 1.CrossRef Rose S, Laan MJ. Why match? Investigating matched case–control study designs with causal effect estimation. Int J Biostat. 2009;5(1):Article 1.CrossRef
22.
Zurück zum Zitat Stirling E, Jeffery J, Johnson N, Dias J. Are radiographic measurements of the displacement of a distal radial fracture reliable and reproducible? Bone Joint J. 2016;98-B(8):1069–73.CrossRef Stirling E, Jeffery J, Johnson N, Dias J. Are radiographic measurements of the displacement of a distal radial fracture reliable and reproducible? Bone Joint J. 2016;98-B(8):1069–73.CrossRef
23.
Zurück zum Zitat Watson NJ, Asadollahi S, Parrish F, Ridgway J, Tran P, Keating JL. Reliability of radiographic measurements for acute distal radius fractures. BMC Med Imaging. 2016;16(1):44.CrossRef Watson NJ, Asadollahi S, Parrish F, Ridgway J, Tran P, Keating JL. Reliability of radiographic measurements for acute distal radius fractures. BMC Med Imaging. 2016;16(1):44.CrossRef
Metadaten
Titel
Comparison of fracture healing and long-term patient-reported functional outcome between dorsal and volar plating for AO C3-type distal radius fractures
verfasst von
Paphon Sa-ngasoongsong
Manuela Rohner-Spengler
Dimitri E. Delagrammaticas
Reto Hansjörg Babst
Frank J. P. Beeres
Publikationsdatum
27.02.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 3/2020
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-019-01100-w

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