Abstract
Objective:To present our experience on intramedullary nailing device Sonoma Wrx (Sonoma Orthopedic Products Inc., Santa Rosa, CA, USA) used for internal fixation of extra-articular or simple intra-articular distal radius fractures in adult population.Methods:This study was conducted from February 2011 to October 2016. A total of 48 patients (mean age 47.3±5.6 years, 35.4% females) with distal radius fracture, who underwent intramedullary distal radius fixation by using Sonoma Wrx were included in this retrospective study. Clinical outcome measures (range of motion [ROM], visual analog scale [VAS]), functional outcomes (Disabilities of the Arm, Shoulder and Hand [DASH] score and Gartland-Werley score), radiographic scores (Stewart score) and parameters (radial inclination, volar tilt, radial height, radio-ulnar variance) and complications were evaluated.Results:The total surgery time was 24.3±2.3 minutes. Patients were followed up for 24.7±3.4 weeks. Complete fracture union was obtained at 5.5±0.9 weeks. The postoperative low VAS pain score (1.6±0.93) and high ROM values (76.7° for extension, 78.5° for supination, 80.1° for flexion, and 82.3° for pronation) indicated a very good clinical outcome. DASH score of 8.3±1.5 and Gartland-Werley score of 2.8±4.1 showed good functional outcome. The radiographic Stewart score was 1.0±1.2. Radial inclination, volar tilt, and radial height significantly increased (p<0.001), and radio-ulnar variance decreased (p=0.001) with surgery. No postoperative complication was recorded in 40 patients (83.3%).Conclusions:Sonoma Wrx, which is an expansible intramedullary elastic locking distal radius nail, offers a good alternative technique for internal fixation of unstable distal radius fractures with the advantage of minimum soft-tissue dissection and related postoperative complications.
Highlights
Distal radius fractures are among the most common injuries accounting for 15-25% of all fractures.[1]
We aimed to present our experience on clinical, functional and radiological outcomes of internal fixation of extra-articular or simple intra-articular distal radius fractures by using intramedullary nailing device Sonoma Wrx in adult population aged over 40 years
The distal radius fracture was caused by fall (56.2%), vehicle accident (22.9%), or sports injury (16.7%)
Summary
Distal radius fractures are among the most common injuries accounting for 15-25% of all fractures.[1]. Distal radius fracture is a common entity, there are many controversies on its diagnosis, classification, treatment, and evaluation of outcomes.[4,5] Various surgical techniques for fixation of extra- and intra-articular distal radius fractures have been described without consensus on. Intramedullary nailing has been introduced as a less invasive technique for internal fixation of both intra- and extra-articular distal radius fractures and for correction of post-traumatic deformity.[7,8,9] With the advantages of minimum soft-tissue dissection, intramedullary nailing promotes effective fracture stabilization and healing.[10] Clinical studies showed that in comparison to volar plating, intramedullary nailing provides better or comparable early postoperative functional outcomes and reduce the incidence of carpal tunnel syndrome, a major complication of distal radius fracture.[10,11,12]
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