Die-punch Fractures Of Distal Radius Research Articles

Double-column Die-punch fractures of distal radius treated with butterfly plate fixation via Henry approach

To explore clinical effect of open reduction and internal fixation with Henry's approach butterfly plate in treating double-column Die-punch fractures of distal radius. From January 2018 to June 2021, 26 patients with double-column Die-column distal radius were treated with open reduction and internal fixation through Henry's surgical approach and using distal radius volar column plate(butterfly plate), including 14 males and 12 females, aged from 20 to 75 years old with an average age of (44.2±3.4) years old. Postopertaive complications were observed, Gartland-Werley score at 12 months after opertaion was used to evaluate wrist joint function. All 26 patients were followed up from 10 to 18 months with an average of(13.4±0.8) months. All fractures were obtained fracture union, the time ranged from 8.5 to 15.8 weeks with an average of (11.4±0.5) weeks. All incisions healed at stageⅠwithout infection, nerve injury and internal fixation failure occurred. Postoperative Gartland-Werley score at 12 months was (3.65±0.36), and 16 patients got excellent result, 8 good and 2 moderate. Open reduction and internal fixation with butterfly plate for the treatment of double-column Die-punch fractures of the distal radius through volar Henry approach could obtain satisfactory clinical outcomes.

Wrist arthroscopic treatment of Die-punch fracture of distal radius

To evaluate the effect of open reduction assisted by wrist arthroscopy in the treatment of Diepunch fracture of the distal radius. The clinical data of 50 patients with die punch fracture of distal radius from December 2015 to May 2017 were analyzed retrospectively, including 31 males and 19 females, aged 20 to 45 (34.12±2.56) years. All patients were treated with open reduction and internal fixation of volar plate through volar approach under the assistance of wrist arthroscope. The range of wrist movement and Cooney wrist function score before and after treatment were compared. All patients were followed up with an average of 18 months. DR scan showed that all fractures healed and no shortening of radial axis. Three cases of incision infection occurred and disappeared after treatment. At 18 months after operation, the range of wrist movement was significantly larger than that before operation (P<0.05) . At 18 months after operation, Cooney wrist function score was higher than that before operation (P<0.05) , excellent in 33 cases, good in 13 cases, fair in 3 cases and poor in 1 case. The treatment of die punch fracture of the distal radius with open reduction assisted by arthroscopy can restore the flatness of the joint surface, promote the recovery of the function of the wrist joint quickly, and has high safety, which is worth popularizing.

Comparison of radiographic and functional results of die-punch fracture of distal radius between volar locking plating (VLP) and external fixation (EF)

PurposeThe aim of this study is to investigate the radiographic and functional results of die-punch fracture of distal radius treated by volar locking plate (VLP) or external fixation (EF).MethodsBetween January 2015 and June 2018, 87 patients who were treated with EF or VLP were included in this study. At postoperative 6 months and at least 12 months, radiographic and functional outcomes were evaluated, and compared between two groups using SPSS 21.0.ResultsThe follow-up period was 15.6 months in average, and at the mean 8.5 weeks bony union was achieved in all patients. At 6-month visit, patients in VLP group had significantly better wrist flexion (79.2° vs. 71.8°) and pronation (79.5° vs. 75.2°) than those in EF group, but the difference was non-significant at the last visit (> 12 months); as for other parameters, no significant differences were observed. No significant difference was found between both groups in term of volar tilt, radial inclination, radial height, ulnar variance, or Gartland–Werley score and DASH. The articular step-off was significantly greater in EF than VLP group (0.6 mm vs. 0.3 mm, p < 0.001). The overall incidence of complications seemed higher in EF group (25% vs. 14%), but not approaching to the statistical significance level.ConclusionsPatients with VLP fixation of die-punch fractures had better wrist flexion and pronation at 6-month visit and more favorable wrist joint congruence at the last visit, but ultimately their outcome was comparable with those treated by EF.

Surgical treatment of old die-punch fractures of distal radius

Objective To report the effects of surgical treatment of old die-punch fractures of the distal radius. Methods A retrospective study of case series was made of the 21 old die-punch fractures of the distal radius which had been surgically treated from January 2012 to January 2017 at Department of Orthopaedics, Shandong Provincial Hospital. There were 13 males and 8 females, aged from 34 to 63 years (average, 46.9 years). According to the preoperative definite diagnoses by the X-ray and CT images, there were 14 metacarpal compression fractures and 7 dorsal compression fractures. The palmar approach was used in 13 cases, the dorsal approach in 7 and the combined approach in one. Autogenous iliac bone grafting was performed for all the cases. Their preoperative and postoperative Cooney scoring and visual analogue scale (VAS) of the wrist, and postoperative complications as well, were observed and recorded. Results This cohort was followed up for 8 to 14 months (average, 9.2 months). All their postoperative wounds healed by the first intention. Their Cooney functional scores of the wrist were, respectively, 58.5±4.2 and 84.0±3.1 points preoperatively and at the final follow-up, and their corresponding VAS scores 7.6±0.9 and 3.4±1.3 points, showing significant differences between preoperation and the final follow-up (P<0.05). Carpal arthritis was observed in one case. Conclusion For old die-punch fractures of the distal radius, surgical treatment can obviously reduce pain, improve function of the wrist and enhance the quality of life of the patients. Key words: Wrist joint; Fracture fixation, internal; Range of motion, articular; Die-punch fractures

Surgical treatment of die-punch fracture of the distal radius

Objective To explore the treatment outcomes of surgical management of die-punch fractures of the distal radius.Methods Fifteen cases of die-punch fractures of distal radius with displacement and unsatisfactory reduction were operated between January 2005 and December 2011.The fractures were confirmed by Ⅹ-ray and CT scans.There were 4 cases of dorsal fractures,1 case of volar fracture,2 cases of split fractures,5 cases of fracture collapse and 3 cases of split fractures associated with collapse.Of the 15 cases,3 cases were accompanied with distal radio-ulnar joint dissociation and 3 cases accompanied by ulnar styloid fracture.Volar surgical approach was taken for all the types except the dorsal fractures which were treated via dorsal approach.In this group,2.4 mm or 2.7 mm anatomical titanium plate was used in 6 cases,3.5 mm plate in 3 cases,screws in 3 cases,Kirschner wires in 1 case and Kirschner wires combined with external fixator in 2 cases.Of the 3 cases accompanied by distal radio-ulnar joint dissociation,one was still unstable after reduction and was fixed with Kirschner wire for 5 weeks.The other two had bone grafting.Results Primary healing of incisions was achieved in all the patients.There were no injuries to the nerves and vessels,no loosening or breakage of the implants and no fracture nonunion.All 15 cases were follow-up for 9 to 28 months with an average of 13 months.Mild traumatic arthritis of the wrist was seen in 1 case that had unsatisfactory fracture reduction.Wrist function was assessed according to Sarmiento scale and was rated as excellent in 9 cases,good in 5 cases and fair in 1 case,with an excellent and good rate of 93.3％.Conclsion Die-punch fracture of the distal radius is a special intra-articular fracture.Early surgical management should be conducted for cases with fracture displacement and unsatisfactory fracture reduction to obtain good results. Key words: Fractures, bone; Fracture fixation; Distal radius