Résultats préliminaires de l’ostéosynthèse des fractures du radius distal par plaque antérieure verrouillée en PEEK

Abstract

Introduction Volar plates have emerged as a popular method of treatment for internal fixation of displaced distal radius fractures. The radiolucency of the PEEK volar locking plate allows for the observation of bone details and facilitates peroperative reduction and radiographic follow-ups. The purpose of this study was to evaluate the clinical and radiological outcomes of this plate for displaced distal radius fractures. Methods Thirty-three consecutive distal radius fractures treated with PEEK volar locking plate were prospectively reviewed. The patients comprised 23 women and 10 men with an average age of 53 years (17 to 81 years). According to the AO fracture classification, 21 patients were type A, one patient was type B and 11 patients were type C. The dominant hand was involved in 39% of cases. The surgical procedure and postoperative rehabilitation were uniformly performed in all patients. The functional assessment was evaluated using the patient rated wrist evaluation (PRWE). The range of motion and grip strength of the operated wrist were measured and compared to the contralateral wrist. Volar tilt, radial inclination and ulnar variance were measured using standard radiographs. Results At the minimum follow-up time of 6 months, the mean PRWE was 10.7 points. Comparing the operated and contralateral wrist, the mean range of motion in flexion-extension was 144.7° and 150.5° ( P = 0.34), in prono-supination was 161.3° and 163° ( P = 0.54), and in radial and ulnar inclination was 49° and 52° ( P = 0.44), respectively. The grip strength was 98.8% for the contralateral side if the operated side was dominant and 82.4% if it was non-dominant. Comparing the operated wrist to the contralateral wrist, the mean volar tilt was 7.7° and 9° ( P = 0.09), the mean radial inclination was 21° and 21° ( P = 0.99) and the mean ulnar variance was −1.35 mm and −1.56 mm ( P = 0.6), respectively. There were four complications (12%) comprising two complex regional pain syndrome, one frozen shoulder and one De Quervain's tenosynovitis + however, each complication had a favorable evolution with conservative treatment. There was no material-related complication. Conclusion The PEEK volar locking plate was shown to be a safe and effective treatment for distal radius fractures. It restored and maintained acceptable reduction, and had a complication rate comparable to standard volar locking plates after a minimum of 6 months of follow-up.