Comparative analysis of treatment technique in patients with distal radius fractures

Cover Page


Cite item

Full Text

Abstract

The purpose of the study was to compare long-term results of surgical treatment of patients with fractures of the distal the radius with use of external fixation and angle stable plates, to make reasonable selection of optimal method of surgery for fractures of this localization. Material and methods. Surgical treatment completed 81 patients (34 men and 47 women) with 81 fractures of the distal radius: 49 patients were operated using angle stable plates (group I), 32 - external fixation (group II). The results of the treatment was assessed using clinical, radiological indicators, DASH questionnaire. Results. One year after surgery in group I we received 81,6% excellent and 18.4% good treatment outcomes, in group II - 71,8% excellent, 15.6% good and 12.5% fair results. Conclusion. Extra-articular fractures of type A are applicable all kinds of operations. However, closed reduction and external fixation has a number of advantages over plate fixation. Type B fractures virtually eliminate the use of external fixation because of the difficulty to achieve precision (anatomic) reduction the fragments. Intra-articular comminuted fractures (type C) require precise reduction with the restoration of the integrity of the articular facet and stable fixation of the whole period of callus formation for early movement in the joint. The results of the study showed that the volar angle stable plates provide these conditions.

About the authors

V. V. Khominets

Kirov Medical Military Academy

Author for correspondence.
Email: noemail@neicon.ru
Russian Federation

M. V. Tkachenko

Kirov Medical Military Academy

Email: tkachenko_med@mail.ru
Russian Federation

V. V. Syrtsov

Kirov Medical Military Academy

Email: noemail@neicon.ru
Russian Federation

V. S. Ivanov

Kirov Medical Military Academy

Email: noemail@neicon.ru
Russian Federation

References

  1. Бейдик О.В., Котельников Г.П., Островский Н.В. Остеосинтез спицевыми и стержневыми аппаратами внешней фиксации. Самара: Перспектива; 2002. 208 с.
  2. Голубев И.О., Крупаткин А.И., Максимов А.А., Меркулов М.В., Бушуев О.М., Ширяева Г.Н., Кутепов И.А., Гришин В.М. Хирургическое лечение неправильно сросшихся переломов дистального метаэпифиза лучевой кости. Вестник травматологии и ортопедии им. Н.Н. Приорова. 2013; (3):51-58.
  3. Губочкин Н.Г., Ткаченко М.В., Умников А.С. Опыт хирургического лечения переломов дистального метаэпифиза костей предплечья. Травматология и ортопедия России. 2008; (2, Приложение):25.
  4. Кавалерский Г.М., Гаркави А.В., Волыков П.Г. Оперативное лечение внутрисуставных переломов дистального метаэпифиза лучевой кости с применением пластин с угловой стабильностью - LCP. Медицинская помощь. 2005; (6):23-27.
  5. Лазарев А.Ф., Солод В.И. Биологичный погружной остеосинтез на современном этапе. Вестник травматологии и ортопедии им. Н.Н. Приорова. 2003; (3):20-26.
  6. Семенкин О.М. Хирургическое лечение больных с переломами дистального метаэпифиза лучевой кости. Вестник травматологии и ортопедии им. Н.Н. Приорова. 2010; (4):84-89.
  7. Шаповалов В.М., Хоминец В.В., Михайлов С.В. Основы внутреннего остеосинтеза. М.: ГЭОТАР- Медиа; 2009. 240 с.
  8. Bartl C., Stengel D., Bruckner T., Gebhard F. The treatment of displaced intra-articular distal radius fractures in elderly patients. Dtsch Arztebl Int. 2014; 111(46):779-787.
  9. Chung K.C., Spilson S.V. The frequency and epidemiology of hand and forearm fractures in United States. Rev J Hand SurgAm. 2001; 26:29-33.
  10. Fernandes D.L., Flury M.C. History, evolution and biomechanics of externals fixation of the wrist joint. J Injury. 1994; 25(4):213.
  11. Frykman G. Fractures of the distal radius. Acta Orthop Scand. 1967; 108 (Supl.):151-153.
  12. Garcia-Elias M., Mathoulin C.L. Intra-articular fractures of the distal radius (AO types C3, with special focus in C3.3), open approach. In: Articular injury of the wrist. Stuttgart: Thieme; 2014. p. 105-117.
  13. Grewal R., Perey B., Wilmink M., Stothers K. A randomized prospective study on the treatment of intra-articular distal radius fractures: open reduction and internal fixation with dorsal plating versus mini open reduction, percutaneous fixation, and external fixation. J Hand Surg Am. 2005; 30:764-772.
  14. Kreder H.J., Agel J., McKee M.D. A randomized, controlled trial of distal radius fractures with metaphyseal displacement but without joint incongruity: closed reduction and casting versus closed reduction, spanning external fixation, and optional percutaneous K-wires. J Orthop Trauma. 2006; 20:115.
  15. Li-hai Z., Ya-nan W., Zhi M., Li-cheng Z., Hong-da L., Huan Y., Xiao-xie L., Pei-fu T. Volar locking plate versus external fixation for the treatment of unstable distal radial fractures: a meta-analysis of randomized controlled trials. J Surg Res. 2015; 193(1):324-333.
  16. Marcheix P.S., Dotzis A., Benko P.E. Extension fractures of the distal radius in patients older than 50: a prospective randomized study comparing fixation using mixed pins or a palmar fixed-angle plate. J Hand Surg Eur Vol. 2010; 35:646-651.
  17. McPeak L.A., Stiers W.M., Cope D.N. Disability evaluation following traumatic brain injury. Phys Med Rehabil Clin N Am. 2001; 12(3):587-601.
  18. Melone C.P. Distal radius fractures patterns of articular fragmentation. Hand Clin. 1993; 24 (2):239-253.
  19. Muller M.E., Nazarian S., Koch P. Classification AO des fractures. Berlin Spinger Verlag; 1987.
  20. Older T.M., Stabler G.V., Cassebaum W.H. Colles’ fracture: evaluation and selection of therapy. J Trauma. 1965; (5):469-474.
  21. Perren S.M. Evolution and rational of locked internal fixator technology. In-troductory remarks. Injury. 2001; 32 (2):39.
  22. Peng B., Wang J., Mao F. Comparison of efficacy between the surgical treatment and plaster external fixation for treatment of unstable distal radius fractures. Zhongguo Gu Shang. 2013; 26(1):41-46.
  23. Rikli D.A., Regazzoni P. Fractures of the distal end of the radius treated by internal fixation and early function: a preliminary report of 20 cases. J Bone Joint Surg Br. 1996; 78:588-592.
  24. Roh Y.H., Lee B.K., Baek J.R., Noh J.H., Gong H.S., Baek G.H. A randomized comparison of volar plate and external fixation for intra-articular distal radius fractures. J Hand Surg Am. 2015; 40(1):34-41.
  25. Windolf J. Surgical or conservative treatment in fracture of the distal radius? Dtsch Arztebl Int. 2014; 111(46):777-778.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2015


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 82474 от 10.12.2021.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies