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Type C distal radial fractures treated with conventional AO plates: an easy and cost-saving solution in a locking plate era

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Abstract

Purpose

C-type distal radial fractures remain challenging fractures. Currently locking plates are very popular because of their length preserving, stability. A considerable drawback is the high cost. Since 2003 we have been using mini AO plates (2.7 mm) as an alternative. We analysed our results and performed a cost analysis.

Methods

Retrospective analysis was performed of all patients operated upon between 2003 and 2008 for C type distal radius fractures. Reduction was achieved with mini AO plates, applied in a buttress fashion, with ligamentotaxis. Rehabilitation consisted of immediate mobilisation. Pre- and postoperative X-rays, operative results and patient charts were reviewed. Furthermore, we prospectively evaluated the functional results using VAS, DASH and Mayo wrist scores. Lastly, we assessed the implant costs and compared them to locking plates.

Results

Thirty-four patients were treated with a mean age of 49 years. Mean radial shortening improved 2 mm; dorsal and radial angulation improved 23 and 4°, respectively. At consolidation (eight weeks) the average radial shortening was 0.75 mm, a volar angulation of 3°, and 21° of radial angulation. Functional results were excellent, demonstrated by a mean VAS score less than 1, a DASH score of 12 and a Mayo wrist score of 87. Compared to locking plates, there was an overall reduction in material costs of 15,300 Euro.

Conclusions

Our technique has excellent biomechanical stability, enabling immediate functional rehabilitation, good anatomical and functional outcome with significantly lower costs.

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References

  1. Augat P, Buhren V (2010) Modern implant design for the osteosynthesis of osteoporotic bone fractures. Orthopade 39:397–406

    Google Scholar 

  2. Chen NC, Jupiter JB (2007) Management of distal radial fractures. J Bone Joint Surg Am 89:2051–2062

    Google Scholar 

  3. Vasenius J (2008) Operative treatment of distal radius fractures. Scand J Surg 97:290–296

    Google Scholar 

  4. Henry MH (2008) Distal radius fractures: current concepts. J Hand Surg Am 33:1215–1227

    Google Scholar 

  5. Martineau PA, Berry GK, Harvey EJ (2010) Plating for distal radius fractures. Hand Clin 26:61–69

    Google Scholar 

  6. Benson LS, Minihane KP, Stern LD, Eller E, Seshadri R (2006) The outcome of intra-articular distal radius fractures treated with fragment-specific fixation. J Hand Surg Am 31:1333–1339

    Google Scholar 

  7. Mackenney PJ, McQueen MM, Elton R (2006) Prediction of instability in distal radial fractures. J Bone Joint Surg Am 88:1944–1951

    Google Scholar 

  8. Finsen V, Rod O, Rod K, Rajabi B, lm-Paulsen PS, Russwurm H (2012) The relationship between displacement and clinical outcome after distal radius (Colles’) fracture. J Hand Surg Eur. Jun 21 [Epub ahead of print]

  9. Handoll HH, Madhok R (2003) Surgical interventions for treating distal radial fractures in adults. Cochrane Database Syst Rev 3:CD003209

    Google Scholar 

  10. Handoll HH, Madhok R, Howe TE (2006) Rehabilitation for distal radial fractures in adults. Cochrane Database Syst Rev 3:CD003324

  11. Egol KA, Walsh M, Romo-Cardoso S, Dorsky S, Paksima N (2010) Distal radial fractures in the elderly: operative compared with nonoperative treatment. J Bone Joint Surg Am 92:1851–1857

    Google Scholar 

  12. Orbay JL (2000) The treatment of unstable distal radius fractures with volar fixation. Hand Surg 5:103–112

    Google Scholar 

  13. Protopsaltis TS, Ruch DS (2008) Volar approach to distal radius fractures. J Hand Surg Am 33:958–965

    Google Scholar 

  14. Downing ND, Karantana A (2008) A revolution in the management of fractures of the distal radius? J Bone Joint Surg Br 90:1271–1275

    Google Scholar 

  15. Yoon A, Grewal R (2012) Management of distal radius fractures from the North American perspective. Hand Clin 28:135–144

    Google Scholar 

  16. Jupiter JB, Marent-Huber M (2009) Operative management of distal radial fractures with 2.4-millimeter locking plates. A multicenter prospective case series. J Bone Joint Surg Am 91:55–65

    Google Scholar 

  17. Warwick D, Prothero D, Field J, Bannister G (1993) Radiological measurement of radial shortening in Colles’ fracture. J Hand Surg Br 18:50–52

    Google Scholar 

  18. Hull P, Baraza N, Gohil M, Whalley H, Mauffrey C, Brewster M, Costa ML (2011) Volar locking plates versus k-wire fixation of dorsally displaced distal radius fractures-a functional outcome study. J Trauma 70(6):E125–128

    Google Scholar 

  19. Egol K, Walsh M, Tejwani N, McLaurin T, Wynn C, Paksima N (2008) Bridging external fixation and supplementary Kirschner-wire fixation versus volar locked plating for unstable fractures of the distal radius: a randomised, prospective trial. J Bone Joint Surg Br 90:1214–1221

    Google Scholar 

  20. Grewal R, MacDermid JC, King GJ, Faber KJ (2011) Open reduction internal fixation versus percutaneous pinning with external fixation of distal radius fractures: a prospective, randomized clinical trial. J Hand Surg Am 36:1899–1906

    Google Scholar 

  21. Sommer C, Brendebach L, Meier R, Leutenegger A (2001) Distal radius fractures—retrospective quality control after conservative and operative therapy. Swiss Surg 7:68–75

    Google Scholar 

  22. Dicpinigaitis P, Wolinsky P, Hiebert R, Egol K, Koval K, Tejwani N (2004) Can external fixation maintain reduction after distal radius fractures? J Trauma 57:845–850

    Google Scholar 

  23. Peine R, Rikli DA, Hoffmann R, Duda G, Regazzoni P (2000) Comparison of three different plating techniques for the dorsum of the distal radius: a biomechanical study. J Hand Surg Am 25:29–33

    Google Scholar 

  24. Rikli DA, Regazzoni P (2000) The double plating technique for distal radius fractures. Tech Hand Up Extrem Surg 4:107–114

    Google Scholar 

  25. Chou YC, Chen AC, Chen CY, Hsu YH, Wu CC (2011) Dorsal and volar 2.4-mm titanium locking plate fixation for AO type C3 dorsally comminuted distal radius fractures. J Hand Surg Am 36:974–981

    Google Scholar 

  26. Gereli A, Nalbantoglu U, Kocaoglu B, Turkmen M (2010) Comparison of palmar locking plate and K-wire augmented external fixation for intra-articular and comminuted distal radius fractures. Acta Orthop Traumatol Turc 44(3):212–219

    Google Scholar 

  27. Hollevoet N, Vanhoutie T, Vanhove W, Verdonk R (2011) Percutaneous K-wire fixation versus palmar plating with locking screws for Colles’ fractures. Acta Orthop Belg 77(2):180–187

    Google Scholar 

  28. Khamaisy S, Weil YA, Safran O, Liebergall M, Mosheiff R, Khoury A (2011) Outcome of dorsally comminuted versus intact distal radial fracture fixed with volar locking plates. Injury 42(4):393–396

    Google Scholar 

  29. McFadyen I, Field J, McCann P, Ward J, Nicol S, Curwen C (2011) Should unstable extra-articular distal radial fractures be treated with fixed-angle volar-locked plates or percutaneous Kirschner wires? A prospective randomised controlled trial. Injury 42(2):162–166

    Google Scholar 

  30. Rikli DA, Regazzoni P (1996) 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 78(4):588–592

    Google Scholar 

  31. Gavaskar AS, Muthukumar S, Chowdary N (2012) Fragment-specific fixation for complex intra-articular fractures of the distal radius: results of a prospective single-centre trial. J Hand Surg Eur 37(8):765–771

    Google Scholar 

  32. Ng CY, McQueen MM (2011) What are the radiological predictors of functional outcome following fractures of the distal radius? J Bone Joint Surg Br 93(2):145–150

    Google Scholar 

  33. Brogren E, Hofer M, Petranek M, Dahlin LB, Atroshi I (2011) Fractures of the distal radius in women aged 50 to 75 years: natural course of patient-reported outcome, wrist motion and grip strength between 1 year and 2–4 years after fracture 1. J Hand Surg Eur :568–576

  34. Hull P, Baraza N, Whalley H, Brewster M, Costa M (2010) Dorsally displaced fractures of the distal radius—a study of preferred treatment options among UK trauma and orthopaedic surgeons. Hand Surg 15(3):185–191

    Google Scholar 

  35. Riggs BL, Melton LJ III (1995) The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 17(5 Suppl):505S–511S

    Google Scholar 

  36. Jupiter JB, Marent-Huber M (2010) Operative management of distal radial fractures with 2.4-millimeter locking plates: a multicenter prospective case series. Surgical technique. J Bone Joint Surg Am 92(Suppl 1 Pt 1):96–106

    Google Scholar 

  37. Huard S, Blanchet N, Leclerc G, Rochet S, Lepage D, Garbuio P, Obert L (2010) Fractures of the distal radius in patients over 70 years old: Volar plates or K-wires? Chir Main 29(4):236–241

    Google Scholar 

  38. Lee YS, Wei TY, Cheng YC, Hsu TL, Huang CR (2012) A comparative study of Colles’ fractures in patients between fifty and seventy years of age: percutaneous K-wiring versus volar locking plating. Int Orthop 36(4):789–794

    Google Scholar 

  39. Voigt C, Lill H (2006) What advantages does volar plate fixation have over K-wire fixation for distal radius extension fractures in the elderly? Unfallchirurg 109(10):845–854

    Google Scholar 

Download references

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All authors declare that they have no conflicts of interests.

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Correspondence to Michael Bemelman.

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Twigt, B., Bemelman, M., Lansink, K. et al. Type C distal radial fractures treated with conventional AO plates: an easy and cost-saving solution in a locking plate era. International Orthopaedics (SICOT) 37, 483–488 (2013). https://doi.org/10.1007/s00264-012-1761-9

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  • DOI: https://doi.org/10.1007/s00264-012-1761-9

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