Authors : Muhsin Dursun

Volume/Issue : Volume 9 - 2024, Issue 11 - November

Google Scholar : https://tinyurl.com/rs59jbf3

Scribd : https://tinyurl.com/5n8vdpj2

DOI : https://doi.org/10.38124/ijisrt/IJISRT24NOV129

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Objective: Outcomes of the treatment of intra-articular distal radius fractures seen in patients above 50 years with volar locked plates were evaluated.  Study design: Twenty Eight patients (8 female and 20 male) treated in our clinic with volar locked plates because of intra-articular distal radius fractures were evaluated after a 17-month (range 8-30 months) follow-up. Mean age of the patients was 45.2 (range 50-64) years. Fractures were classified according to Frykman and AO classifications. According to the Frykman classification, 2 patients had type 3 (7%), 1 patient had type 4 (5.5%), 14 patients had type 7 (50%) and 11 patients had type 8 (37.5%) fractures. According to the AO classification, 6 patients had B2 (23.5%), 4 patients had C1 (14%), 11 patients had C2 (37.5%) and 7 patients had C3 (25%) fractures. All patients were evaluated clinically and radiologically. Clinical outcomes of the patients were evaluated using Gartland and Werley’s evaluation scores and DASH-T scores. Radiologic outcomes were evaluated according to the radiologic evaluation criteria modified by Steward et al.  Results: According to the evaluation scores of Gartland and Werley, 20 patients yielded excellent (72%), 5 patients good (18%) and 3 patients moderate (10%) results. Mean DASH-T score of the patients was 34 (range 31 to 40).  Conclusions: Treatment of intra-articular distal radius fractures seen above 50 years of age with volar locked plates is an efficient and safe method. Use of volar locked plates reduces the complication risk of reduction loss and need for grafts in osteoporotic fractures.

Keywords : Fractures Of The Radius; Forearm Injuries; Colles Fractures.

References :

1. Jupiter JB. Fractures Of The Distal End Of The Radius. J Bone Joint Surg. Am. 1991; 73(A): 461-469..
2. Bradway JK, Amadio PC. Open reduction and internal fixation of displaced, comminuted intraarticular fractures of the distal end of the radius. J Bone Joint Surg 1989; 71(A): 839.
3. Cooney WP,Linscheid RL, Dobyns JH: Fractures and dislocation in wrist: Rockwood and Green’s Fractures in adults. 3 th edt. Rockwood CA, Green DP, Bucholz RW (Eds). JB Lippincott co. Newyork., Volume-I, Chapter 8. P:563-638.
4. Knirk JL, Jupiter JB. Intra-articular fractures of the distal end of the radius in young adults. J Bone Joint Surg 1986; 68-A(5): 647-59.
5. Kozin S.H, Wood M.B. Early soft tissue complications after fractures of the distal part of the radius. J Bone Joint Surg 1993 ; 75A: 144-153.
6. Short WH, Palmer AK, Wernwr FW: A biomechanical study of distal radial fractures. J Hand Surg 1987; 12A: 529-534.
7. Palmer AK. Fractures of the distal radius. Operative Hand Surgery ; 3th edition. Churchill Livingstone, 1991;929-941.
8. La Fontaine M, Hardy D, Delience P.H. Stability assessment of distal radius fractures. Injury 1989; 20: 208-210.
9. Frykman G, Tooma GS, Boyka K, Henderson R. Comparison of eleven external fixators for treatment of unstable wrist fractures. J Hand Surg 1989; 14A : 247-254.
10. Fernandez DL: Geissler WB: Treatment of displaced articuler fractures of the radius. J Hand Surg1991,16-a(3):375-84.
11. Gartland JJ Jr, Werley WC. Evaluation of healed Colles’ fractures. J  Bone Joint Surg 1951; 33-A: 895-907.
12. Hanel DP. Treatment of intraartiküler fractures. In Trumble TE (Ed) Hand Surgery Update. Hand, Elbow and  Shoulder  3rd ed. American  Society for Surgery of the Hand, Rosemont,2002;  pp : 105-121.
13. Herrera M, Chapman CB, Roh M, Strauch RJ, Rosenwasser MP: Treatment of unstable distal radius fractures with cancellous allograft and external fixation. J Hand Surg 1999, 24-A(6):1269-78.
14. Jones KG: Colles’ fracture. J Arkansas Med Soc 1976; 73: 244-247
15. Weber S.C, Szabo R.M. Severely comminuted distal radial fracture as an unsolved problem: Complications associated with external fixation and pins and plaster techniques. J Hand Surg 1986; 11A: 157-165.
16. Hastings H 2nd, Leibovic SJ: Indications and techniques of open reduction. İnternal fixation of distal radius fractures. Orthop Clin North Am 1993,24(2):309-26.
17. Jupiter JB, Lipton H: The operatif treatment of Intraarticular fractures of the distal radius. Clin Orthop 1993,292:48-61.
18. Arora R, Roth T, Kralinger F,Blauth M: A Representative Case of Osteoporotic Distal Radius Fracture. J Orthop Trauma 2008; 22: 116-120.
19. Lauber P, Pfeiffer KM: Open osteosynthesis of distal radius fractures. Results and long-term follow-up. Unfallheilkunde 1984, 87(5):185-95.
20. Letsch R, Schmit-Neuerburg KP, Towfigh H: Indications and results of plate osteosynthesis of the distal radius. Langenbecks Arch Chir 1984, 364:363-8.
21. Willis AA,  Kutsumi K, Zobitz ME, Cooney WP: Internal Fixation of Dorsally Displaced Fractures of the Distal Part of the Radius. A Biomechanical Analysis of Volar Plate Fracture Stability. J Bone Joint Surg Am 2006, 88: 2411-2417.
22. Chung KC, Watt AJ, Kotsis SV, Margaliot Z: Treatment of Unstable Distal Radial Fractures with the Volar Locking Plating System. J Bone Joint Surg Am 2006, 88: 2687-94.
23. Taylor KF, Parks BG, Segalman KA: Biomechanical Stability of a Fixed-Angle Volar Plate Versus Fragment-Specific Fixation System: Cyclic Testing in a C2-Type Distal Radius Cadaver Fracture Model. J Hand Surg 2006; 31A: 373-378.
24. Orbay JL, Fernandez DL: Volar fixed-angle plate fixation for unstable distal radius fractures in the elderly patient. J Hand Surg 2004; 29-A(1):96-102.