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Unidirektionale vs. multidirektionale palmare winkelstabile Osteosynthese bei instabilen distalen Radiusfrakturen

Vergleichende Analyse mit der 2,4-mm-LDR- vs. 2,7-mm-Matrix-Smartlock-Platte

Unidirectional versus multidirectional palmar locking osteosynthesis of unstable distal radius fractures

Comparative analysis with LDR 2.4 mm versus 2.7 mm matrix-smartlock

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Zusammenfassung

Einleitung

Zur operativen Stabilisierung distaler Radiusfrakturen kommen multidirektionale winkelstabile Platten als Weiterentwicklung der unidirektionalen Plattensysteme immer häufiger zum Einsatz. In wieweit sie zu einer Verbesserung der Behandlungsergebnisse führen, ist Gegenstand dieser Studie.

Patienten und Methoden

In dieser prospektiven Kohortenstudie wurden 40 Patienten mit C1- und C2-Extensionsfrakturen operativ mit uni- und multidirektionalen Platten behandelt und nach 12,3 (12–15) Monaten nachuntersucht. Die intraoperativen, funktionellen (Neutral-Null-Methode), radiologischen sowie subjektiven Daten (DASH-Score, VAS) wurden ermittelt.

Ergebnisse

Die intraoperative Durchleuchtungszeit war in der unidirektionalen Gruppe um 58 s kürzer als in der multidirektionalen Gruppe. Alle Frakturen heilten ohne Komplikation aus. Die radiologischen, subjektiven (DASH-Score) sowie objektiven Ergebnisse waren in beiden Gruppen gut, ein Unterschied bestand nicht.

Schlussfolgerung

Die unidirektionalen Platten eignen sich genauso gut wie die multidirektionalen zur Therapie von C1- und C2-Frakturen, wobei die Durchleuchtungszeit bei den multidirektionalen Platten länger ist.

Abstract

Introduction

Due to advances in the development of the unidirectional locking plates there is now an increased use of multidirectional palmar locking plates in the treatment of distal radius factures. The purpose of this study was to evaluate a possible improvement of the treatment and results.

Patients and methods

This prospective cohort study investigated 40 patients with C1 and C2 Colles’ fractures who had been treated with unidirectional and multidirectional locking plates. The average time for the follow-up examinations was 12.3 months (range 12–15 months) after surgery. The intra-operative functional (neutral-zero method), radiological and subjective (DASH score, VAS) results were evaluated.

Results

The intra-operative fluoroscopy time of the unidirectional group was 58 s shorter compared to the multidirectional group. All fractures healed without any complication. The radiological, subjective (DASH score) and objective results for both groups were good and showed no differences.

Conclusion

Unidirectional palmar locking plates are equally suited for the therapy of C1 and C2 fractures as multidirectional palmar locking plates but multidirectional plates require a longer fluoroscopy time.

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Literatur

  1. Al-Rashid M, Theivendran K, Craigen MAC (2006) Delayed ruptures of the extensor tendon secondary to the use of volar locking compression plates for distal radial fractures. J Bone Joint Surg [Br] 88:1610–1612

    Google Scholar 

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

    Article  PubMed  Google Scholar 

  3. Arora R, Lutz M, Zimmermann R et al (2007) Grenzen der palmaren winkelstabilen Plattenosteosynthese bei instabilen distalen Radiusfrakturen. Handchir Mikrochir Plast Chir 39:34–41

    Article  CAS  PubMed  Google Scholar 

  4. Carter PR, Frederick HA, Laseter GF (1998) Open reduction and internal fixation of unstable distal radius fractures with a low-profile plate: a multicenter study of 73 fractures. J Hand Surg [Am] 23:300–307

    Google Scholar 

  5. Doi K, Hattori Y, Otsuka K et al (1999) Intraarticular fractures of the distal aspect of the radius: arthroscopically assisted reduction compared with open reduction and internal fixation. J Bone Joint Surg [Am] 81:1093–1110

    Google Scholar 

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

    CAS  PubMed  Google Scholar 

  7. Gehrmann SV, Windolf J, Kaufmann RA (2008) Distal radius fracture management in elderly patients: a literature review. J Hand Surg [Am] 33:421–429

    Google Scholar 

  8. Kambouroglou GK, Axelrod TS (1998) Complications of the AO/ASIF titanium distal radius plate system in internal fixation of the distal radius: a brief report. J Hand Surg [Am] 23:737–741

    Google Scholar 

  9. Kandemir U, Matityahu A, Desai R et al (2008) Does a volar locking plate provide equivalent stability as a dorsal nonlocking plate in a dorsally comminuted distal radius fracture? A biomechanical study. J Orthop Trauma 22:605–610

    Article  PubMed  Google Scholar 

  10. 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] 30B(5):499–503

    Google Scholar 

  11. Kettler M, Kuhn V, Schieker M et al (2008) Do we need to include osteoporosis in today’s classification of distal radius fractures? J Orthop Trauma 22:S79–S82

    Article  PubMed  Google Scholar 

  12. Mehling I, Meier M, Schlör U, Krimmer H (2007) Multidirektionale winkelstabile Versorgung der instabilen distalen Radiusfraktur. Handchir Mikrochir Plast Chir 39:29–33

    Article  CAS  PubMed  Google Scholar 

  13. Nana AD, Joshi A, Lichtman DM (2005) Plating of the distal radius. J Am Acad Orthop Surg 13:159–171

    PubMed  Google Scholar 

  14. Owen RA, Melton LJ III, Johnson KA et al (1982) Incidence of Colles‘ fracture in a North American community. Am J Public Health 72:605–607

    Article  CAS  PubMed  Google Scholar 

  15. Rader CP, Rauber C, Rehm KE, Koebke J (1995) Internal fixation of the distal radius. A comparative, experimental study. Arch Orthop Trauma Surg 114:340–343

    Article  CAS  PubMed  Google Scholar 

  16. Rozental TD, Makhni EC, Day CS et al (2008) Improving evaluation and treatment for osteoporosis following distal radial fractures. A prospective randomized intervention. J Bone Joint Surg [Am] 90:953–961

    Google Scholar 

  17. 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] 31:359–365

    Google Scholar 

  18. Rozental TD, Beredjiklian PK, Bozentka DJ (2003) Functional outcome and complications following two types of dorsal plating for unstable fractures of the distal radius. J Bone Joint Surg [Am] 85:1956–1960

    Google Scholar 

  19. Sakhaii M, Groenewold U, Klonz A, Reilmann H (2003) Ergebnisse nach palmarer Plattenosteosynthese mit der winkelstabilen T-Platte bei 100 distalen Radiusfrakturen. Eine prospektive Studie. Unfallchirurg 106:272–280

    Article  CAS  PubMed  Google Scholar 

  20. Schupp A, Tuttlies C, Möhlig T, Siebert HR (2003) Der distale Speichenbruch. Winkelstabile Osteosynthese mit 2.4 mm Formplatten. Ist der Aufwand gerechtfertigt? Chirurg 74:1009–1017

    Article  CAS  PubMed  Google Scholar 

  21. Schmelzer-Schmied N, Wieloch P, Martini AK, Daecke W (2008) Comparison of external fixation, locking and non-locking palmar plating for unstable distal radius fractures in the elderly. Int Orthop 12 [Epub ahead of print]

  22. Thielke KH, Wagner T, Bartsch S, Echtermeyer V (2003) Winkelstabile, volare Plattenosteosynthese komplexer artikulärer Frakturen am distalen Radius. Lösung einer Problemfraktur? Chirurg 74:1057–1063

    Article  PubMed  Google Scholar 

  23. Voigt C, Lill H (2006) Welche Vorteile bietet die volare Plattenosteosynthese gegenüber der Kirschner-Drahtstabilisierung bei distalen Radiusextensionsfrakturen des alten Menschen? Unfallchirurg 109:848–854

    Google Scholar 

  24. Windolf J, Hakimi M, Schädel-Höpfner M (2008) Ergebnisse der palmaren winkelstabilen Plattenosteosynthese am distalen Radius. Trauma Berufskrankh 10:236–240

    Article  Google Scholar 

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  1. Klinik für Unfall- und Handchirurgie, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland

    M. Hakimi,  P. Jungbluth, S. Gehrmann, J. Nowak, J. Windolf & M. Wild

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  1. M. Hakimi
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  2. P. Jungbluth
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  3. S. Gehrmann
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  4. J. Nowak
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  5. J. Windolf
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  6. M. Wild
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Correspondence to P. Jungbluth.

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Hakimi, M., Jungbluth, P., Gehrmann, S. et al. Unidirektionale vs. multidirektionale palmare winkelstabile Osteosynthese bei instabilen distalen Radiusfrakturen. Unfallchirurg 113, 210–216 (2010). https://doi.org/10.1007/s00113-009-1708-9

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  • DOI: https://doi.org/10.1007/s00113-009-1708-9

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