Abstract
BackgroundVolar locking plating through the flexor carpi radialis is a well-established technique for treating unstable distal radial fractures, with few reported complications. In certain circumstances, including metaphyseal comminuted fractures, bridge plating through a pronator quadratus (PQ)-sparing approach may be required to preserve the soft tissue envelope. This study describes our prospective experience with bridge plating through indirect reduction.MethodsThirty-three wrists (four 23A2, six 23A3, 15 23C1, and eight 23C2) underwent bridge plating through a PQ-sparing approach with indirect reduction from June 2006 to December 2010. Mean patient age was 56.8 years (range, 25–83 years), and the mean follow-up period was 47.5 months (range, 36–84 months). Changes in radiologic parameters (volar tilt, radial inclination, radial length, and ulnar variance) were analyzed, and functional results at final follow-up were evaluated by measuring the Modified Mayo Wrist Score (MMWS) and Modified Gartland-Werley Score (MGWS).ResultsAll wrists achieved bone healing without significant complications after a single operation. At final follow-up, radial length was restored from an average of 3.7 mm to 11.0 mm, as were radial inclination, from 16.4° to 22.5°, and volar tilt, from − 9.1° to 5.5°. However, radial length was overcorrected in three wrists, and two experienced residual dorsal tilt. Excellent and good results on the MGWS were achieved in 30 wrists (90.9%). The average MMWS outcome was 92.6 (range, 75–100).ConclusionOur experience with bridge plating was similar to that previously reported in the earlier publications. Compared with the conventional technique, bridge plating through a PQ-sparing approach may help in managing metaphyseal comminuted fractures of both cortices with a reduced radio-ulnar index.
Highlights
Volar locking plating through the flexor carpi radialis is a well-established technique for treating unstable distal radial fractures, with few reported complications
The increasing incidence of complex fracture patterns after high-energy trauma and the demand for early return to activities of daily living have increased the number of patients requiring operative intervention to treat distal radial fractures
Many factors influence the management of distal radial fractures, including the low complication rate of the open method, lesion size, and the easy manipulation and restoration of anatomic continuity using closed maneuvers
Summary
Volar locking plating through the flexor carpi radialis is a well-established technique for treating unstable distal radial fractures, with few reported complications. In certain circumstances, including metaphyseal comminuted fractures, bridge plating through a pronator quadratus (PQ)-sparing approach may be required to preserve the soft tissue envelope. Fractures may be reduced directly and fixed with volar locking plates [1,2,3]. This method has yielded lower complication rates, ranging from 7% to 24%, than other treatment modalities [4]. Many factors influence the management of distal radial fractures, including the low complication rate of the open method, lesion size, and the easy manipulation and restoration of anatomic continuity using closed maneuvers. The only advantages of MIPO were reported to be the preservation of the pronator quadratus (PQ) muscle and
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
