nach oben

European Journal of Orthopaedic Surgery & Traumatology

Erschienen in:

01.04.2015 | Original Article

Plate fixation of distal radius fracture and related complications

verfasst von: Laurent Obert, Francois Loisel, Sonia Huard, Séverin Rochet, Daniel Lepage, Gregoire Leclerc, Patrick Garbuio

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 3/2015

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Distal radius fractures are common. In cases where surgical treatment is needed, volar plates can be used to obtain stable, long-lasting fixation. The design of these plates has continually improved over the years, but complications remain a problem.

Purpose

The goal of this study was to evaluate the types of complications that occur with different types of volar plates with a view towards preventing them.

Materials and methods

The emergency department at our hospital saw 524 patients with distal radius fractures between 2006 and 2008. Some of these were treated surgically with a volar plate. All of the post-operative complications were documented.

Results

With a minimum follow-up of 6 months, 152 patients who had undergone plate fixation were reviewed: 31 had received plates with non-locking screws or uniaxial locking screws and 121 had received plates with polyaxial locking screws. The complication rate was similar in these two groups (16.1 and 16.5 %, respectively). The main complications were tendon ruptures and problems related to the plate itself.

Discussion

Plate-related complications have been described in published studies, but few of these studies link them to the plate design or surgical technique. Manufacturers must continue to refine these plates to minimise their thickness while keeping their strength. Surgeons must be sure to use a highly exacting technique.

Dumontier C, Herzberg G (2001) Symposiums-Recent fractures of the distal radius in adults. Rev Chir Orthop 87(5):1S67

Obert L (2010) Fixation of distal radius fracture in adult (Ostéosynthèse des fractures récentes de l’extrémité distale du radius de l’adulte). Conférences d’enseignement Sofcot 2010, Elsevier, 48–79. doi:10.1016/B978-2-8101-0057-6.00003-0

Egol KA, Kubiak EN, Fulkerson E, Kummer FJ, Koval KJ (2004) Biomechanics of locked plates and screws. J Orthop Trauma 18:488–493CrossRefPubMed

Pichon H, Chergaoui A, Jager S, Carpentier E, Jourdel F, Chaussard C, Saragaglia D (2008) Volar fixed angle plate LCP 3.5 for dorsally distal radius fracture. About 24 cases. Rev Chir Orthop Rep Appar Mot 94:152–159CrossRef

Sakhaii M, Groenewold U, Klonz A, Reilmann H (2003) Results after palmar plate-osteosynthesis with angularly stable T-plate in 100 distal radius fractures: a prospective study. Unfallchirurg 106:272–280CrossRefPubMed

Gasse N, Lepage D, Pem R, Bernard C, Lerais JM, Garbuio P, Obert L (2011) Anatomical and radiological study applied to distal radius surgery. Surg Radiol Anat 33:485–490CrossRefPubMed

Laulan J, Bismuth JP, Sicre G, Garaud P (1997) The different types of algodystrophy after fracture of the distal radius: predictive criteria of outcome after 1 year. J Hand Surg: Br Eur 22:441–447CrossRef

Sennwald GR, Della Santa D (2001) Unstable fracture of the distal radius and its treatment: comparison of three techniques: external fixation, intramedullary pinning and AO plates. Chir Main 20:218–225CrossRefPubMed

Arora R, Lutz M, Hennerbichler A, Krappinger D, Espen D, Gabl M (2007) Complications following internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma 21:316–322CrossRefPubMed

10.

Kaempffe FA, Wheeler DR, Peimer CA, Hvisdak KS, Ceravolo J, Senall J (1993) Severe fractures of the distal radius: effect of amount and duration of external fixator distraction on outcome. J Hand Surg Am 18:33–41CrossRefPubMed

11.

Orbay JL, Fernandez DL (2002) Volar fixation for dorsally displaced fractures of the distal radius: a preliminary report. J Hand Surg Am 27:205–215CrossRefPubMed

12.

Drobetz H, Kutscha-Lissberg E (2003) Osteosynthesis of distal radial fractures with a volar locking screw plate system. Int Orthop 27:1–6PubMedCentralPubMed

13.

Constantine KJ, Clawson MC, Stern PJ (2002) Volar neutralization plate fixation of dorsally displaced distal radius fractures. Orthopedics 25:125–128PubMed

14.

Bell JS, Wollstein R, Citron ND (1998) Rupture of flexor pollicis longus tendon: a complication of volar plating of the distal radius. J Bone Joint Surg Br 80:225–226CrossRefPubMed

15.

Nunley JA, Rowan PR (1999) Delayed rupture of the flexor pollicis longus tendon after inappropriate placement of the pi plate on the volar surface of the distal radius. J Hand Surg Am 24:1279–1280CrossRefPubMed

16.

Benson EC, DeCarvalho A, Mikola EA, Veitch JM, Moneim MS (2006) Two potential causes of EPL rupture after distal radius volar plate fixation. Clin Orthop Relat Res 451:218–222CrossRefPubMed

17.

Skoff HD (2003) Postfracture extensor pollicis longus tenosynovitis and tendon rupture: a scientific study and personal series. Am J Orthop 32:245–247PubMed

18.

Goubier JN, Zouaoui S, Saillant G (2001) The complications of the distal radius fractures (Les complications des fractures du radius distal). Rev Chir Orthop 87:118

19.

Wagner M (2003) General principles for the clinical use of the LCP. Injury 34(Suppl 2):B31–B42CrossRefPubMed

20.

Bégué T (2007) Biomechanical and clinical aspects of plates with locked screws (Aspects biomécaniques et cliniques des plaques à vis verrouillées). Rev Chir Orthop 93(7 Suppl 1):29. doi:10.1016/S0035-1040(07)79382-0

21.

Kamano M, Honda Y, Kazuki K, Yasuda M (2002) Palmar plating for dorsally displaced fractures of the distal radius. Clin Orthop Relat Res 397:403–408CrossRefPubMed

22.

Dumont C, Fuchs M, Folwaczny EK, Heuermann C, Sturmer KM (2003) Results of palmar T-plate osteosynthesis in unstable fractures of the distal radius. Chirurg 74:827–833CrossRefPubMed

23.

Schutz M, Kolbeck S, Spranger A, Arndt-Kolbeck M, Haas NP (2003) Palmar plating with the locking compression plate for dorsally displaced fractures of the distal radius—first clinical experiences. Zentralbl Chir 128:997–1002CrossRefPubMed

24.

Orbay JL, Fernandez DL (2004) Volar fixed-angle plate fixation for unstable distal radius fractures in the elderly patient. J Hand Surg Am 29:96–102CrossRefPubMed

25.

Krimmer H, Pessenlehner C, Hasselbacher K, Meier M, Roth F, Meier R (2004) Palmar fixed angle plating systems for instable distal radius fractures. Unfallchirurg 107:460–467CrossRefPubMed

26.

Prokop A, Jubel A, Andermahr J, Rehm KE (2004) Do angle stable implants provide advantages? Treatment of distal radius fractures with the locking compression plate (LCP). Eur J Orthop Surg Traumatol 14:10–15CrossRef

27.

Margaliot Z, Haase SC, Kotsis SV, Kim HM, Chung KC (2005) A meta-analysis of outcomes of external fixation versus plate osteosynthesis for unstable distal radius fractures. J Hand Surg Am 30:1185–1199CrossRefPubMed

28.

Gruber G, Bernhardt GA, Kohler G, Gruber K (2006) Surgical treatment of distal radius fractures with an angle fixed bar palmar plating system: a single center study of 102 patients over a 2-year period. Arch Orthop Trauma Surg 126:680–685CrossRefPubMed

29.

Kreder HJ, Hanel DP, Agel J, McKee M, Schemitsch EH, Trumble TE, Stephen D (2005) Indirect reduction and percutaneous fixation versus open reduction and internal fixation for displaced intra-articular fractures of the distal radius: a randomised, controlled trial. J Bone Joint Surg Br 87:829–836CrossRefPubMed

30.

Koshimune M, Kamano M, Takamatsu K, Ohashi H (2005) A randomized comparison of locking and non-locking palmar plating for unstable Colles’ fractures in the elderly. J Hand Surg Br 30:499–503CrossRefPubMed

31.

Ruch DS, Papadonikolakis A (2006) Volar versus dorsal plating in the management of intra-articular distal radius fractures. J Hand Surg Am 31:9–16CrossRefPubMed

32.

Rozental TD, Blazar PE (2006) Functional outcome and complications after volar plating for dorsally displaced, unstable fractures of the distal radius. J Hand Surg Am 31:359–365CrossRefPubMed

33.

Rampoldi M, Marsico S (2007) Complications of volar plating of distal radius fractures. Acta Orthop Belg 73:714–719PubMed

Titel: Plate fixation of distal radius fracture and related complications
verfasst von: Laurent Obert
Francois Loisel
Sonia Huard
Séverin Rochet
Daniel Lepage
Gregoire Leclerc
Patrick Garbuio
Publikationsdatum: 01.04.2015
Verlag: Springer Paris
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 3/2015
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-014-1550-9

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Introduction

Purpose

Materials and methods

Results

Discussion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2015

Comparison of short-term results of intraarticular platelet-rich plasma (PRP) and hyaluronic acid treatments in early-stage gonarthrosis patients

Is tranexamic acid clinically effective and safe to prevent blood loss in total knee arthroplasty? A meta-analysis of 34 randomized controlled trials

The Mayo Clinic Department of Orthopedic Surgery: an international foundation

Mechanical evaluation of hip cement spacer reinforcement with stainless steel Kirschner wires, titanium and carbon rods, and stainless steel mesh

High-energy tibial plateau fractures: external fixation versus plate fixation

Medium-term comparison of results in obese patients and non-obese hip prostheses with Metha® short stem