Volar fixation of distal radial fracture using compression plate: clinical and radiographic evaluation of 20 patients

Comparing the effectiveness of mobilization techniques with movement and myofascial techniques in patients following distal radius fractures treated conservatively

Introduction: Fractures of the distal radius are one of the most common types in the upper limb area. They lead to significant reduction in range of mobility, muscle weakness and the occurrence of serious pain. Material and methods: The research involved 20 patients from the Specialist Hand Rehabilitation Centre in Krakow, who were rehabilitated after fractures to the distal radial bone. They were randomly divided into two groups. In group A (n = 10), there were patients who underwent mobilization techniques with movement according to the Mulligan concept as part of their manual work. Group B (n = 10) consisted of patients subjected to myofascial techniques. Functional examination of the hand was carried out twice before and after beginning rehabilitation. The range of active mobility, muscle strength and superficial feeling were examined. Based on the obtained results, functional loss was calculated according to Swanson’s method, Total Active Motion and the sensory index. The obtained results were subjected to statistical analysis using the Excel 10 programme. Results: Significant improvement in hand and muscle strength was noted in both groups. In the group of patients treated with myofascial techniques, better rates of improvement for the tested parameters were obtained than in the group treated with the use of joint mobilization techniques. Conclusions: 1. The applied programme of rehabilitating patients following fracture of the distal radial bone is characterized by statistically significant improvement in hand function. 2. The use of soft-tissue techniques is a more effective method of hand function restitution than the method of mobilization with movement. myofascial techniques, forearm fractures, physiotherapy

PEEK radiolucent plate for distal radius fractures: multicentre clinical results at 12 months follow up

INTRODUCTION

Open reduction and internal fixation (ORIF) with plate and screws represents the recommended treatment for unstable intra-articular distal radius fractures. Although significant progresses in surgical technique have been made, anatomical reconstruction of radio-carpal articular surface still represent a difficult task, especially in multifragmentary fractures. Available PEEK reinforced-carbon fiber composite radiolucent devices allow both an easier and more careful assessment of intra-operative reduction of the articular surface of distal radius and prompt correction of any residual step deformity.

MATERIALS AND METHODS

We retrospectively reviewed clinical and radiological multicentre results of 71 consecutive AO B and C fracture pattern of distal radius treated using the same PEEK reinforced-carbon fiber composite radiolucent plate.

RESULTS

Three patients lost at final follow up and 4 cases with incomplete radiological documentations were excluded from the study. 64 patients (38 females, 26 males) were available and formed the basis of this report. Fracture types included 9 patients with 23-B, 13 patients 23-B2,15 patients with 23-B3,10 patients with 23-C1, 7 patients with 23-C2 and 10 patients with 23-C3. Mean Modified Mayo wrist Score was on average 38.11 (SD 10.1; range 24-75, 95%CI 34.7-41.4), 67.22 (SD 9.6, range 50-90, 95%CI 64-70.4), 90.54 (SD 6.3, range 75-100, 95%CI 88.4-92.6) at one, two and twelve months of follow-up, respectively. A statistically significant difference was found between mean scores at different follow-up periods (p = 0.001). We noted 1 case of distal screw fixation aseptic loosening at 5 months post surgical intervention.

CONCLUSIONS

PEEK reinforced-carbon fiber composite radiolucent plate represents a useful device for treatment of complex distal radius fractures in the adult population. It possesses unique biomechanical properties and allows for an easier anatomical reduction during surgical intervention.

Comparison of outcome of VLCP versus PKEF in the treatment of AO type C2-3 distal radial fractures

Purposes

Fractures of the distal radius are extremely common in adults. However, the optimal management remains controversial, especially in AO type C2-3 (Type23 C2 or C3 of distal radial fracture, according to AO classifications). The purpose of this study was to compare the results of the volar locking compression plate (VLCP) and percutaneous Kirschner-wires combined with external fixation (PKEF) in the treatment of the AO type C2-3 fractures.

Methods

From July 2012 to June 2015, 62 patients with AO type C2-3 fractures, treated by VLCP or PKEF, were included in this retrospective study. Patients were followed up at 3 months, 6 months after operation, and final follow up. Outcomes were assessed by radiographic features in all follow up and by DASH and Sarmiento's modification of the Gartland-Werley score at final follow up.

Rusults

No significant difference was noted between these two groups in terms of volar inclination, ulnar angulation and ulnar variance. There was also no significant difference on DASH score between these two groups. However, according to the Sarmiento's modification of the Gartland-Werley scores, the scores was higher in VLCP group than the PKEF group, and ratings of excellent and good were lower in the VLCP group (P = 0.05).

Conclusions

Both techniques could get satisfactory results in the treatment of AO type C2-3 fractures, but PKEF leads to better wrist function than VLCP .

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This is a retrospective study.

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The purpose of this study was to compare the therapeutic effects of the VLCP and PKEF in the treatment of the AO type C2-3 distal radial fractures.

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Both techniques could get satisfactory results in the treatment of AO type C2-3 fractures, but PKEF leads to better wrist function than VLCP.