SavedAdd your journal

Journals / Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.) / 2019 / Cilt: 30 - Sayı: 3

Comparison of three surgical methods in the treatment of intraarticular comminuted distal radius fractures: Volar locking plate, non-bridging external fixator, and bridging external fixator

Parçalı eklem içi distal radius kırıklarının tedavisinde üç cerrahi yöntemin karşılaştırılması: Volar kilitli plak, köprüsüz eksternal fiksatör ve köprülü eksternal fiksatör

Okan TOK
Mehmet Ali TALMAÇ
Mehmet Akif GÖRGEL
Muharrem KANAR
Hacı Mustafa ÖZDEMİR
Pages
224–232
Publication Date
2022-10-18
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

TheBEF seems to be the least effective treatment option amongthe three surgical methods.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objectives: The aim of this study was to evaluate bothclinical and radiological results of intraarticular comminuteddistal radius fractures treated with volar locking plate (VLP),non-bridging external fixator (NbEF), and bridging externalfixator (BEF).Patients and methods: 95 patients (44 males, 51 females;median age 49 years; interquartile range (IQR), 37 to 60years) who were treated with VLP, NbEF, or BEF due tointraarticular comminuted distal radius fractures betweenJanuary 2010 and April 2014 were evaluated retrospectively.34 of these patients were treated with a VLP (VLP group),30 with a NbEF (NbEF group) and 31 with a BEF (BEFgroup).
📊
Key Findings & Data:In the final follow-up, all patients were evaluatedaccording to clinical and radiological parameters.Results: The median follow-up was 5 (IQR, 4 to 6) years.
💡
Conclusion & Impact:TheBEF seems to be the least effective treatment option amongthe three surgical methods.
🔬Design:Research Article
📍Scope:2010 Verileri
⚙️Variables:Domain Parameters

Abstract

Objectives: The aim of this study was to evaluate bothclinical and radiological results of intraarticular comminuteddistal radius fractures treated with volar locking plate (VLP),non-bridging external fixator (NbEF), and bridging externalfixator (BEF).Patients and methods: 95 patients (44 males, 51 females;median age 49 years; interquartile range (IQR), 37 to 60years) who were treated with VLP, NbEF, or BEF due tointraarticular comminuted distal radius fractures betweenJanuary 2010 and April 2014 were evaluated retrospectively.34 of these patients were treated with a VLP (VLP group),30 with a NbEF (NbEF group) and 31 with a BEF (BEFgroup). In the final follow-up, all patients were evaluatedaccording to clinical and radiological parameters.Results: The median follow-up was 5 (IQR, 4 to 6) years. TheVLP and NbEF groups had better results than the BEF groupin terms of wrist range of motion, loss of grip strength, GreenO’Brien, Mayo Modified Wrist, The Quick Disabilities of theArm, Shoulder, and Hand (QuickDASH) and VAS scores. TheVLP group had the most significant radiological improvement.Conclusion: Although clinical and radiological results forintraarticular comminuted distal radius fractures are moresignificantly improved in patients treated with VLP, favorableresults close to VLP can be also obtained with NbEF. TheBEF seems to be the least effective treatment option amongthe three surgical methods.

Özet

Amaç: Bu çalışmada, volar kilitli plak (VLP), el bileğini köprülemeyen eksternal fiksatör (NbEF) ve köprüleyen eksternal fiksatör (BEF) ile tedavi edilen parçalı eklem içi distal radius kırıklarının klinik ve radyolojik sonuçları değerlendirildi. Hastalar ve yöntemler: Ocak 2010 - Nisan 2014 arasında parçalı eklem içi distal radius kırığı nedeniyle VLP, NbEF veya BEF ile tedavi edilen toplam 95 hasta (44 erkek, 51 kadın; ortanca yaş 49; çeyrekler arası aralık (IQR) 37-60 years) yıl) retrospektif olarak değerlendirildi. Bu hastaların 34’ü VLP (VLP Grubu), 30’u NbEF (NbEF Grubu) ve 31’i BEF (BEF Grubu) ile tedavi edildi. Son kontrol vizitinde, tüm hastalar klinik ve radyolojik parametrelere göre değerlendirildi. Bulgular: Takip süresinin ortanca değeri 5 (IQR, 4-6) yıl idi. El bilek eklemi hareket açıklığı, kavrama kuvveti kaybı, Green O'Brien, Mayo Modifiye El Bileği, QuickDASH ve VAS skorlarına göre VLP ve NbEF grupları, BEF grubuna kıyasla, daha iyi sonuçlara sahipti. Radyolojik parametrelerde en anlamlı iyileşme VLP grubunda görüldü. Sonuç: Her ne kadar parçalı eklem içi distal radius kırıklarının klinik ve radyolojik sonuçlarında en anlamlı iyileşme VLP ile tedavi edilen erişkinlerde görülse de, NbEF ile de VLP’ye yakın olumlu sonuçlar elde edilebilir. Üç cerrahi tedavi yöntemi arasında BEF’in en az etkili seçenek olduğu görülmektedir.

🔖

Cite This Article

TOK, O., TALMAÇ, M. A., GÖRGEL, M. A., KANAR, M., ÖZDEMİR, H. M. (2022). Comparison of three surgical methods in the treatment of intraarticular comminuted distal radius fractures: Volar locking plate, non-bridging external fixator, and bridging external fixator. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.), Cilt: 30 - Sayı: 3, 224–232. https://ajindex.com/articles/498408

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (12)

  1. Wijffels MM, Keizer J, Buijze GA, Zenke Y, Krijnen P, Schep NW, et al. Ulnar styloid process nonunion and outcome in patients with a distal radius fracture: a meta-analysis of comparative clinical trials. Injury 2014;45:1889-95
  2. Rhee PC, Medoff RJ, Shin AY. Complex distal radius fractures: an anatomic algorithm for surgical management. J Am Acad Orthop Surg. 2017;25:77-88
  3. Atroshi I, Brogren E, Larsson GU, Kloow J, Hofer M, Berggren AM. Wrist-bridging versus non-bridging external fixation for displaced distal radius fractures: a randomized assessor-blind clinical trial of 38 patients followed for 1 year. Acta Orthop. 2006;77:445-53
  4. Aldemir C, Duygun F. Is it possible to avoid intra-articular screw penetration with minimal use of fluoroscopy in the application of distal radius volar plate? Eklem Hastalik Cerrahisi. 2017;28:2-6
  5. Seitz WH Jr, Froimson AI, Brooks DB, Postak P, Polando G, Greenwald AS. External fixator pin insertion techniques: biomechanical analysis and clinical relevance. J Hand Surg Am 1991;16:560-3
  6. Abe Y, Doi K, Kuwata N, Yamamoto H, Sunago K, Kawai S. Surgical options for distal radial fractures: indications and limitations. Arch Orthop Trauma Surg 1998;117:188-92
  7. Markiewitz AD, Gellman H. Five-pin external fixation and early range of motion for distal radius fractures. Orthop Clin North Am 2001;32:329-35
  8. Letsch R, Infanger M, Schmidt J, Kock HJ. Surgical treatment of fractures of the distal radius with plates: a comparison of palmar and dorsal plate position. Arch Orthop Trauma Surg 2003;123:333-9
  9. Gradl G, Gradl G, Wendt M, Mittlmeier T, Kundt G, Jupiter JB. Non-bridging external fixation employing multiplanar K-wires versus volar locked plating for dorsally displaced fractures of the distal radius. Arch Orthop Trauma Surg 2013;133:595-602
  10. Yuan ZZ, Yang Z, Liu Q, Liu YM. Complications following open reduction and internal fixation versus external fixation in treating unstable distal radius fractures: Grading the evidence through a meta-analysis. Orthop Traumatol Surg Res. 2018;104:95-103
  11. Weber SC, Szabo RM. Severely comminuted distal radial fracture as an unsolved problem: complications associated with external fixation and pins and plaster techniques. J Hand Surg Am 1986;11:157-65
  12. Ruch DS, McQueen MM. Distal radius and ulna fractures. In: Bucholz RW, Heckman JD, Court-Brown CM, Tornetta P, editors. Rockwood and Green’s fractures in adults, 7th ed. Philadelphia: Wolters Kluver; 2010. p. 829-8