Minimally invasive palmar locking plate for treatment of distal radius fractures

Abstract

Objective To investigate the clinical effects,feasibility,points for attention and complications of treating distal radial fractures through minimally invasive palmar locking plate.Methods A total of 22 patients with distal radial fractures managed by minimally invasive palmar locking plate from August 2009 to August 2010 were enrolled in the study.According to AO classification,there were five patients with type A2 fractures,three with type A3,four with type B1,seven with type B3,two with type C1 and one with type C2.Two vertical or parallel palmar incisions of 2 cm long were performed.The distal transverse incision was along the proximal wrist crease,while the distal and proximal vertical incisions were close to the radial side of flexor carpi radialis.Then,palmar locking plate was inserted through deep pronator quadratus.Results Follow-up period was 10-18 months(mean,12 months).According to Dienst function evaluation criteria,the results were excellent in 13 patients,good in six,fair in three and poor in zero,with excellence rate of 86％.Complications were as follows:one patient had delayed healing of proximal wrist crease incision;one patient had numbness of thenar eminence and the symptom was disappeared three months postoperatively;two patients remained pain on ulnar side of the wrist joint;two patients had limited function of the wrist joint.Conclusions Minimally invasive palmar locking plate is safe,mini-invasive and reliable when treating distal radial fractures,which is conducive to early functional exercise.Furthermore,the method achieves satisfactory appearance of the incision which meets the minimal invasion and thus deserves clinical practice. Key words: Radius fractures; Surgical procedures,minimally invasive; Volar plate