E-ISSN 2277-338X | ISSN 2320-4664
 

Original Research 


Distal radius fractures with diaphyseal involvement:fixation with fixed angle volar plate

Rajesh Chawda.

Abstract
Background: Fractures of the distal radius involving the metaphyseal and diaphyseal junction are commonly the result of high energy trauma, and represent a challenge for the orthopedic surgeon. Fractures are often comminuted: optimal reduction, restoration of normal radial length, and a correct radioulnar relationship may be difficult to achieve. Only a few reports in the literature have studied these lesions, and the best treatment approach is still the source of debate.

Aims & Objective: To evaluate the outcome of fractures of the distal radius with metaphyseal and diaphyseal involvement treated with fixed angle volar plates.

Materials and Methods: Twenty-one patients with fracture of the radius involving the diaphyseal, metaphyseal and epiphyseal parts were treated with fixed angle plate fixation through an extended volar Henry’s approach. Circle wire loops, screws and intrafocal wire fixations were associated in 12 cases. Coexisting ulnar fractures were fixed with plates or K-wires in 8 cases. All patients were prospectively followed using radiographs, physical examination, and DASH (Disabilities of the Arm, Shoulder and Hand) scores.

Results: All fractures except one, which needed a secondary bone graft to achieve consolidation, united by an average of 90 days. One case developed a radioulnar synostosis. Radiographs showed optimal reduction in 17 of 21 cases, with restoration of radial length in all cases and a neutral average ulnar variance. Non-anatomical reduction was associated with the worst results (P = 0.0006). Flexion and extension averaged 62.8 degree and 73.8 degree and pronation and supination 85.2degree and 80.2degree respectively. The average DASH scores were 30 points at 3 months, 14 points at 6 months, and 6.7 points at the time of final follow-up (at an average of 11 months). According to the Mayo wrist rating system, 14 patients showed excellent results, 5 showed good results, and 2 showed fair results.

Conclusion: Fixed angle volar plates were demonstrated to be a safe and efficient treatment in these challenging fractures.

Key words: Distal radius fractures , Diaphyseal involvement , Internal fixation , Fixed angle volar plate


 
ARTICLE TOOLS
Abstract
PDF Fulltext
How to cite this articleHow to cite this article
Citation Tools
Related Records
 Articles by Rajesh Chawda
on Google
on Google Scholar


REFERENCES
1. Orbay J. Volar plate fixation of distal radius fractures. Hand Clin 2005;21:347-54. [DOI via Crossref]    [Pubmed]   
2. Osada D, Kamei S, Masuzaki K, Takai M, Kameda M, Tamai K. Prospective study of distal radius fractures treated with a volar locking plate system. J Hand Surg (Am) 2008;33(5):691-700. [DOI via Crossref]    [Pubmed]   
3. Kaempfe FA, Wheeler, Peimer CA, Hvisdak KS, Ceravolo J, Senall J. Severe fractures of the distal radius: effect of amount and duration of external fixator distraction on outcome. J Hand Surg (Am) 1993;18-A:33-41. [DOI via Crossref]   
4. Papadonikolakis A, Shen J, Garrett JP, Davis SM, Ruch DS. The effect of increasing distraction on digital motion after external fixation of the wrist. J Hand Surg (Am) 2005;30:773-9. [DOI via Crossref]    [Pubmed]   
5. Rizzo M, Katt BA, Carothers JT. Comparison of locked volar plating versus pinning and external fixation in the treatment of unstable intraarticular distal radius fractures. Hand 2008;3(2):111-7. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
6. Ginn TA, Ruch DS, Yang CC, Hanel DP. Use of a distraction plate for distal radial fractures with metaphyseal and diaphyseal comminution. Surgical technique. J Bone Joint Surg Am 2006;88(Suppl 1 Pt 1):29-36. [Pubmed]   
7. Ruch DS, Ginn TA, Yang CC, Smith BP, Rushing J, Hanel DP. Use of a distraction plate for distal radial fractures with metaphyseal and diaphyseal comminution. J Bone Joint Surg Am 2005;87(5):945-54. [DOI via Crossref]    [Pubmed]   
8. Orbay J, Fernandez DL. Volar fixed-angle plate fixation for unstable distal radius fractures in the elderly patient. J Hand Surg (Am) 2004;29-A:97-102.
9. Chung KC, Squitieri L, Kim HM. Comparative outcomes study using the volar locking plating system for distal radius fractures in both young adults and adults older than 60 years. J Hand Surg (Am) 2008;33(6):809-19. [DOI via Crossref]    [Pubmed]   
10. Dennison DG. Open reduction and internal locked fixation of unstable distal ulna fractures with concomitant distal radius fracture. J Hand Surg (Am) 2007;32(6):801-5. [DOI via Crossref]    [Pubmed]   
11. Gschwentner M, Arora R, Wambacher M, Gabl M, Lutz M. Distal forearm fracture in the adult: is ORIF of the radius and closed reduction of the ulna a treatment option in distal forearm fracture? Arch Orthop Trauma Surg 2008;128(8):847-55. [DOI via Crossref]    [Pubmed]   
12. Rogachefsky RA, Lipson SR, Applegate B, Ouellette EA, Savenor AM, McAuliffe JA. Treatment of severely comminuted intra-articular fractures of the distal end of the radius by open reduction and combined internal and external fixation. J Bone Joint Surg Am 2001;83-A(4):509-19. [Pubmed]   
13. McAuliffe JA. Combined internal and external fixation of distal radius fractures. Hand Clin 2005;21(3):395-406. [DOI via Crossref]    [Pubmed]   

How to Cite this Article
Pubmed Style

Rajesh Chawda. Distal radius fractures with diaphyseal involvement:fixation with fixed angle volar plate. Int J Med Sci Public Health. 2014; 3(4): 410-414. doi:10.5455/ijmsph.2014.260120142


Web Style

Rajesh Chawda. Distal radius fractures with diaphyseal involvement:fixation with fixed angle volar plate. http://www.ijmsph.com/?mno=150398 [Access: October 01, 2021]. doi:10.5455/ijmsph.2014.260120142


AMA (American Medical Association) Style

Rajesh Chawda. Distal radius fractures with diaphyseal involvement:fixation with fixed angle volar plate. Int J Med Sci Public Health. 2014; 3(4): 410-414. doi:10.5455/ijmsph.2014.260120142



Vancouver/ICMJE Style

Rajesh Chawda. Distal radius fractures with diaphyseal involvement:fixation with fixed angle volar plate. Int J Med Sci Public Health. (2014), [cited October 01, 2021]; 3(4): 410-414. doi:10.5455/ijmsph.2014.260120142



Harvard Style

Rajesh Chawda (2014) Distal radius fractures with diaphyseal involvement:fixation with fixed angle volar plate. Int J Med Sci Public Health, 3 (4), 410-414. doi:10.5455/ijmsph.2014.260120142



Turabian Style

Rajesh Chawda. 2014. Distal radius fractures with diaphyseal involvement:fixation with fixed angle volar plate. International Journal of Medical Science and Public Health, 3 (4), 410-414. doi:10.5455/ijmsph.2014.260120142



Chicago Style

Rajesh Chawda. "Distal radius fractures with diaphyseal involvement:fixation with fixed angle volar plate." International Journal of Medical Science and Public Health 3 (2014), 410-414. doi:10.5455/ijmsph.2014.260120142



MLA (The Modern Language Association) Style

Rajesh Chawda. "Distal radius fractures with diaphyseal involvement:fixation with fixed angle volar plate." International Journal of Medical Science and Public Health 3.4 (2014), 410-414. Print. doi:10.5455/ijmsph.2014.260120142



APA (American Psychological Association) Style

Rajesh Chawda (2014) Distal radius fractures with diaphyseal involvement:fixation with fixed angle volar plate. International Journal of Medical Science and Public Health, 3 (4), 410-414. doi:10.5455/ijmsph.2014.260120142





Most Viewed Articles
  • Internet addiction among professional courses students: A study from central India
    Arvind Sharma, Rupesh Sahu, Pradeep Kumar Kasar, Richa Sharma
    Int J Med Sci Public Health. 2014; 3(9): 1069-1073
    » Abstract & References » doi: 10.5455/ijmsph.2014.180620142

  • Management of Appendicular Lump: Early exploration Vs conservative management
    Chandra Prakash Pandey, Ram Chandra Kesharwani, Chandra Gopal Singh Chauhan, Manmohan Krishna Pandey, Purnima Mittra, Pramod Kumar, Arshad Raza
    Int J Med Sci Public Health. 2013; 2(4): 1046-1049
    » Abstract & References » doi: 10.5455/ijmsph.2013.230820131

  • Burden of non communicable diseases in India: Setting priority for action
    Kalpa Sharma
    Int J Med Sci Public Health. 2013; 2(1): 7-11
    » Abstract & References » doi: 10.5455/ijmsph.2013.2.7-11

  • Diabetic nephropathy: Progression and pathophysiology
    Deepak N Parchwani, Amit A Upadhyah
    Int J Med Sci Public Health. 2012; 1(2): 59-70
    » Abstract & References » doi: 10.5455/ijmsph.2012.1.59-70

  • Elevated levels of serum uric acid, creatinine or urea in preeclamptic women
    Magna Manjareeka, Sitikantha Nanda
    Int J Med Sci Public Health. 2013; 2(1): 43-47
    » Abstract & References » doi: 10.5455/ijmsph.2013.2.43-47

  • Most Downloaded
  • Minor disorder of pregnancy and its home management
    Lata Gururani, Atul Kumar, Gomathi Mahalingam
    Int J Med Sci Public Health. 2016; 5(4): 684-687
    » Abstract & References » doi: 10.5455/ijmsph.2016.03082015111

  • Association between serum ferritin and thyroid hormone profile in hypothyroidism
    Ashuma Sachdeva, Veena Singh, Isha Malik, Prasanta Saha Roy, Himanshu Madaan, Rajesh Nair
    Int J Med Sci Public Health. 2015; 4(6): 863-865
    » Abstract & References » doi: 10.5455/ijmsph.2015.24012015174

  • Internet addiction among professional courses students: A study from central India
    Arvind Sharma, Rupesh Sahu, Pradeep Kumar Kasar, Richa Sharma
    Int J Med Sci Public Health. 2014; 3(9): 1069-1073
    » Abstract & References » doi: 10.5455/ijmsph.2014.180620142

  • Effect of sleep deprivation on the attitude and performance of medical students, Riyadh, Saudi Arabia
    Hussein Saad Amin, Ibrahim Salamah Almazroua, Abdullah Sulaiman Alsahlan, Mohammed Abdullah Alrishan, Houssam Mourad Elmourad, Mohammed Mansour Alotaibi, Abdulaziz Ibrahim Almohaisin
    Int J Med Sci Public Health. 2016; 5(3): 575-580
    » Abstract & References » doi: 10.5455/ijmsph.2016.17112015207

  • Management of Appendicular Lump: Early exploration Vs conservative management
    Chandra Prakash Pandey, Ram Chandra Kesharwani, Chandra Gopal Singh Chauhan, Manmohan Krishna Pandey, Purnima Mittra, Pramod Kumar, Arshad Raza
    Int J Med Sci Public Health. 2013; 2(4): 1046-1049
    » Abstract & References » doi: 10.5455/ijmsph.2013.230820131

  • Most Cited Articles
  • Zinc: The trace element of major importance in human nutrition and health
    Jayant D Deshpande, Mohini M Joshi, Purushottam A Giri
    Int J Med Sci Public Health. 2013; 2(1): 1-6
    » Abstract & References » doi: 10.5455/ijmsph.2013.2.1-6
    Cited : 57 times [Click to see citing articles]

  • Internet addiction among professional courses students: A study from central India
    Arvind Sharma, Rupesh Sahu, Pradeep Kumar Kasar, Richa Sharma
    Int J Med Sci Public Health. 2014; 3(9): 1069-1073
    » Abstract & References » doi: 10.5455/ijmsph.2014.180620142
    Cited : 23 times [Click to see citing articles]

  • A study on the prevalence of refractive errors among school childern of 7-15 years age group in the field practice areas of a medical college in bangalore
    Pavithra MB, Maheshwaran R, Rani Sujatha MA
    Int J Med Sci Public Health. 2013; 2(3): 641-645
    » Abstract & References » doi: 10.5455/ijmsph.2013.220420131
    Cited : 22 times [Click to see citing articles]

  • Burden of non communicable diseases in India: Setting priority for action
    Kalpa Sharma
    Int J Med Sci Public Health. 2013; 2(1): 7-11
    » Abstract & References » doi: 10.5455/ijmsph.2013.2.7-11
    Cited : 21 times [Click to see citing articles]

  • Non albicans Candida species: its isolation pattern, species distribution, virulence factors and antifungal susceptibility profile
    Sachin Chandrakant Deorukhkar, Santosh Saini
    Int J Med Sci Public Health. 2013; 2(3): 533-538
    » Abstract & References » doi: 10.5455/ijmsph.2013.080320131
    Cited : 20 times [Click to see citing articles]