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Anatomical fit of seven different palmar distal radius plates

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Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The purpose of this study was to compare the anatomical fit of different, precontoured palmar distal radius plates.

Methods

The anatomical fit of seven different types of palmar distal radius plates [Königsee variable fixed-angle radius plate 7/3-hole, Königsee variable fixed-angle radius plate 5/3-hole (Allendorf, Germany), Medartis 2.5 Adaptive TriLock, Medartis 2.5 TriLock, Medartis 2.5 TriLock extraarticular, (Basel, Switzerland), Synthes VA-LCP distal two-column-radius, Synthes LCP extraarticular (Bettlach, Switzerland)] were investigated in 25 embalmed human cadaveric radii. An imprint of the space between the well-positioned plate and the distal radius was attained using a silicone mass and the maximum height of the silicone imprint was digitally measured. The mean maximum imprint height was compared between the seven plates using an analysis of variance with repeated measures and Bonferroni correction for multiple comparisons.

Results

The mean maximum distance between the plates and the radial cortex was <2 mm for all plates. The greatest difference was found with the Medartis Adaptive (1.99 ± 0.45 mm) and the least difference with the Synthes two-column (1.56 ± 0.76 mm), this difference being statistically significant (p = 0.005).

Conclusion

Although there was no complete congruency between the plates and the radial cortex, all distal palmar radius plates investigated in this study presented a reasonable anatomical shape. The Synthes VA-LCP distal two-column-radius plate palmar showed the best anatomical fit. A low profile and optimized anatomical precontouring minimizes irritation of the surrounding soft tissues and should be considered with plate design and implant choice.

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References

  1. Nellans KW, Kowalski E, Chung KC (2012) The epidemiology of distal radius fractures. Hand Clin 28(2):113–125

    Article  PubMed  PubMed Central  Google Scholar 

  2. Henry MH (2008) Distal radius fractures: current concepts. J Hand Surg Am 33(7):1215–1227

    Article  PubMed  Google Scholar 

  3. 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

    PubMed  Google Scholar 

  4. Gradl G, Jupiter J, Pillukat T, Knobe M, Prommersberger KJ (2013) Corrective osteotomy of the distal radius following failed internal fixation. Arch Orthop Trauma Surg 133(8):1173–1179

    Article  PubMed  Google Scholar 

  5. Mehling I, Muller LP, Rommens PM (2012) Comparative biomechanical studies on implant systems for the treatment of distal radius fractures: what are the conclusions for clinical practice? Handchir Mikrochir Plast Chir 44(5):300–305

    Article  PubMed  CAS  Google Scholar 

  6. Lutsky K, McKeon K, Goldfarb C, Boyer M (2009) Dorsal fixation of intra-articular distal radius fractures using 2.4-mm locking plates. Tech Hand Up Extrem Surg 13(4):187–196

    Article  PubMed  Google Scholar 

  7. Lutsky K, Boyer M, Goldfarb C (2013) Dorsal locked plate fixation of distal radius fractures. J Hand Surg Am 38(7):1414–1422

    Article  PubMed  Google Scholar 

  8. Tarallo L, Mugnai R, Zambianchi F, Adani R, Catani F (2013) Volar plate fixation for the treatment of distal radius fractures: analysis of adverse events. J Orthop Trauma 27(12):740–745

    Article  PubMed  Google Scholar 

  9. Soong M, van Leerdam R, Guitton TG et al (2011) Fracture of the distal radius: risk factors for complications after locked volar plate fixation. J Hand Surg Am 36(1):3–9

    Article  PubMed  Google Scholar 

  10. Kitay A, Swanstrom M, Schreiber JJ et al (2013) Volar plate position and flexor tendon rupture following distal radius fracture fixation. J Hand Surg Am 38(6):1091–1096

    Article  PubMed  Google Scholar 

  11. Souer JS, Ring D, Matschke S et al (2010) Comparison of functional outcome after volar plate fixation with 2.4-mm titanium versus 3.5-mm stainless-steel plate for extra-articular fracture of distal radius. J Hand Surg Am 35(3):398–405

    Article  PubMed  Google Scholar 

  12. Court-Brown CM, Caesar B (2006) Epidemiology of adult fractures: a review. Injury 37(8):691–697

    Article  PubMed  Google Scholar 

  13. Kamath AF, Zurakowski D, Day CS (2006) Low-profile dorsal plating for dorsally angulated distal radius fractures: an outcomes study. J Hand Surg Am 31(7):1061–1067

    Article  PubMed  Google Scholar 

  14. Rozental TD, Beredjiklian PK, Bozentka DJ (2003) Functional outcome and complications following two types of dorsal plating for unstable fractures of the distal part of the radius. J Bone Joint Surg Am 85-A(10):1956–1960

    PubMed  Google Scholar 

  15. Yu YR, Makhni MC, Tabrizi S et al (2011) Complications of low-profile dorsal versus volar locking plates in the distal radius: a comparative study. J Hand Surg Am 36(7):1135–1141

    Article  PubMed  Google Scholar 

  16. 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

    PubMed  CAS  Google Scholar 

  17. Fowler JR, Ilyas AM (2013) Prospective evaluation of distal radius fractures treated with variable-angle volar locking plates. J Hand Surg Am 38(11):2198–2203

    Article  PubMed  Google Scholar 

  18. Kainz H, Dall’ara E, Antoni A et al (2013) Calcium phosphate cement augmentation after volar locking plating of distal radius fracture significantly increases stability. Eur J Orthop Surg Traumatol 24(6):869–875

    Article  PubMed  Google Scholar 

  19. Högel F, Mair S, Eberle S et al (2013) Distal radius fracture fixation with volar locking plates and additional bone augmentation in osteoporotic bone: a biomechanical study in a cadaveric model. Arch Orthop Trauma Surg 133(1):51–57

    Article  PubMed  Google Scholar 

  20. Orbay JL, Touhami A (2006) Current concepts in volar fixed-angle fixation of unstable distal radius fractures. Clin Orthop Relat Res 445:58–67

    PubMed  Google Scholar 

  21. Hershman SH, Immerman I, Bechtel C et al (2013) The effects of pronator quadratus repair on outcomes after volar plating of distal radius fractures. J Orthop Trauma 27(3):130–133

    Article  PubMed  Google Scholar 

  22. Brown EN, Lifchez SD (2011) Flexor pollicis longus tendon rupture after volar plating of a distal radius fracture: pronator quadratus plate coverage may not adequately protect tendons. Eplasty 11:461–466

    Google Scholar 

  23. Tosti R, Ilyas AM (2013) Prospective evaluation of pronator quadratus repair following volar plate fixation of distal radius fractures. J Hand Surg Am 38(9):1678–1684

    Article  PubMed  Google Scholar 

  24. Buzzel JE, Weikert DR, Watson JT, Lee DH (2008) Precontoured fixed-angle volar distal radius plates: a comparison of anatomic fit. J Hand Surg Am 33(7):1144–1152

    Article  Google Scholar 

  25. Imatani J, Akita K, Yamaguchi K et al (2012) An anatomical study of the watershed line on the volar, distal aspect of the radius: implications for plate placement and avoidance of tendon ruptures. J Hand Surg Am 37(8):1550–1554

    Article  PubMed  Google Scholar 

  26. Limthongthang R, Bachoura A, Jacoby SM, Osterman AL (2014) Distal radius volar locking plate design and associated vulnerability of the flexor pollicis longus. J Hand Surg Am 39(5):852–860

    Article  PubMed  Google Scholar 

  27. Klug RA, Press CM, Gonzalez MH (2007) Rupture of the flexor pollicis longus tendon after volar fixed-angle plating of a distal radius fracture: a case report. J Hand Surg Am 32(7):984–988

    Article  PubMed  Google Scholar 

  28. Cross AW, Schmidt CC (2008) Flexor tendon injuries following locked volar plating of distal radius fractures. J Hand Surg Am 33(2):164–167

    Article  PubMed  Google Scholar 

  29. 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(5):316–322

    Article  PubMed  Google Scholar 

  30. Esenwein P, Sonderegger J, Gruenert J et al (2013) Complications following palmar plate fixation of distal radius fractures: a review of 665 cases. Arch Orthop Trauma Surg 133(8):1155–1162

    Article  PubMed  CAS  Google Scholar 

  31. Beck JD, Harness NG, Spencer HT (2014) Volar plate fixation failure for volar shearing distal radius fractures with small lunate facet fragments. J Hand Surg Am 39(4):670–678

    Article  PubMed  Google Scholar 

  32. Bassi RS, Krishnan KM, Dhillon SS, Deshmukh SC (2003) Palmar cortical angle of the distal radius: a radiological study. J Hand Surg Br 28(2):163–164

    Article  PubMed  CAS  Google Scholar 

  33. Gasse N, Lepage D, Pem R et al (2011) Anatomical and radiological study applied to distal radius surgery. Arch Orthop Trauma Surg 33(6):485–490

    CAS  Google Scholar 

  34. Evans S, Ramasamy A, Deshmukh SC (2014) Distal volar radial plates: How anatomical are they? Orthop Traumatol Surg Res 100(3):293–295

    Article  PubMed  CAS  Google Scholar 

  35. Schneppendahl J, Windolf J, Kaufmann R (2012) Distal radius fractures: current concepts. J Hand Surg Am 37(8):1718–1725

    Article  PubMed  Google Scholar 

  36. Matschke S, Wentzensen A, Ring D et al (2011) Comparison of angle stable plate fixation approaches for distal radius fractures. Injury 42(4):385–392

    Article  PubMed  CAS  Google Scholar 

  37. Lerch S, Sextro HG, Wilken F, Wittenberg CE (2009) Clinical and radiological results after distal radius fracture: intramedullary locking nail versus volar locking plate osteosynthesis. Z Orthop Unfall 147(5):547–552

    PubMed  CAS  Google Scholar 

  38. Figl M, Weninger P, Liska M, Hofbauer M, Leixnering M (2009) Volar fixed-angle plate osteosynthesis of unstable distal radius fractures: 12 months results. Arch Orthop Trauma Surg 129(5):661–669

    Article  PubMed  Google Scholar 

  39. Mehling I, Meier M, Schlör U, Krimmer H (2007) Multidirectional palmar fixed-angle plate fixation for unstable distal radius fracture. Handchir Mikrochir Plast Chir 39(1):29–33

    Article  PubMed  CAS  Google Scholar 

  40. Drobetz H, Weninger P, Grant C et al (2013) More is not necessarily better. A biomechanical study on distal screw numbers in volar locking distal radius plates. Injury 44(4):535–539

    Article  PubMed  Google Scholar 

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Acknowledgments

J.O. and J.D. did not and will not receive any financial benefit in any form. No benefits in any form have been received related directly or indirectly to the subject of this article. KJB receive travel support and payments for ongoing consultancy and fees for participation in review activities from Medartis™. The Medartis plates used in this study were kindly provided by Medartis™.

Conflict of interest

There is no conflict of interest of all authors.

Ethical standard

The study was approved by the Ethics Committee of the Medical Faculty of the University of Cologne (Reference Number 13-190).

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Authors and Affiliations

  1. Department of Orthopaedics and Trauma Surgery, Medical Faculty, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany

    Johannes Oppermann, Max Wacker, Gregor Stein, Hans-Philipp Springorum, Klaus J. Burkhart, Peer Eysel & Jens Dargel

  2. Department of Anatomy I, Medical Faculty, University of Cologne, Bldg. 35, Kerpener Strasse 62, 50931, Cologne, Germany

    Johannes Oppermann & Wolfram Friedrich Neiss

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  1. Johannes Oppermann
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  2. Max Wacker
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  3. Gregor Stein
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Correspondence to Johannes Oppermann.

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Oppermann, J., Wacker, M., Stein, G. et al. Anatomical fit of seven different palmar distal radius plates. Arch Orthop Trauma Surg 134, 1483–1489 (2014). https://doi.org/10.1007/s00402-014-2072-y

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  • DOI: https://doi.org/10.1007/s00402-014-2072-y

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