Surgical comfort and clinical outcomes of MIPO with an extra-short plate designed for distal radius fractures.
Clinical outcomes
Distal radius
Extra-short locking plate
Fracture
Mini-invasive approach
Pronator quadratus
Journal
European journal of orthopaedic surgery & traumatology : orthopedie traumatologie
ISSN: 1432-1068
Titre abrégé: Eur J Orthop Surg Traumatol
Pays: France
ID NLM: 9518037
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
24
05
2020
accepted:
10
09
2020
pubmed:
22
9
2020
medline:
19
8
2021
entrez:
21
9
2020
Statut:
ppublish
Résumé
Volar locking plates (VLPs) are increasingly used for distal radius fractures (DRFs) with minimally invasive plate osteosynthesis (MIPO), but surgery learning curves could be long. The purpose of this study was to assess a new extra-short plate with two locking diaphyseal divergent screws, specifically designed for MIPO, preserving the pronator quadratus muscle. This retrospective study consisted of three phases: (i) the evaluation of surgical comfort with the incision size and the duration of 59 consecutive surgeries using the extra-short plate in DRFs; (ii) the verification of the implant ability to maintain radiographic indices compared immediately postoperatively and at consolidation. They included radial inclination (RI), volar tilt (VT) and ulnar variance (UV); (iii) the assessment of clinical outcomes at last follow-up through: pain measured on the visual analogue scale (VAS), QuickDASH score, patient-rated wrist evaluation (PRWE) score, grip strength, range of motion and complications. In the first phase: mean incision size was 32 mm, and mean operative time was 28.5 min. In the second phase, there was no statistical difference between the two measures of the indices studied. In the third phase, mean follow-up time was 14.2 months, VAS score was 1.1, QuickDASH score was 11.4/100, and PRWE score was 9.5/100. Flexion was 91%, extension was 94%, and grip strength was 86% compared to the contralateral side. The surgical comfort may be related to short operative time and incision. The implant allowed maintaining the radiographic indices without secondary displacement. Functional clinical outcomes were satisfactory. This extra-short plate design belongs to a novel generation of VLPs.
Identifiants
pubmed: 32955698
doi: 10.1007/s00590-020-02791-3
pii: 10.1007/s00590-020-02791-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
481-490Références
Obert L, Rey PB, Uhring J, Gasse N, Rochet S, Lepage D et al (2013) Fixation of distal radius fractures in adults: a review. Orthop Traumatol Surg Res. 99:216–234
doi: 10.1016/j.otsr.2012.03.023
Knox J, Ambrose H, McCallister W, Trumble T (2007) Percutaneous pins versus volar plates for unstable distal radius fractures: a biomechanic study using a cadaver model. J Hand Surg Am. 32:813–817
doi: 10.1016/j.jhsa.2007.03.015
Loisel F, Bouilloux X, Uhring J, Rochet S, Obert L (2015) Early postoperative improvements in the QuickDASH score after distal radius fracture are related to the type of surgical treatment. Eur J Orthop Surg Traumatol 25:865–869
doi: 10.1007/s00590-015-1626-1
Haerle M, Schaller HE, Mathoulin C (2003) Vascular anatomy of the palmar surfaces of the distal radius and ulna: its relevance to pedicled bone grafts at the distal palmar forearm. J Hand Surg Br. 28:131–136
doi: 10.1016/S0266-7681(02)00279-6
Lebailly F, Zemirline A, Facca S, Gouzou S, Liverneaux P (2014) Distal radius fixation through a mini-invasive approach of 15 mm. PART 1: a series of 144 cases. Eur J Orthop Surg Traumatol 24:877–890
doi: 10.1007/s00590-013-1363-2
Liverneaux P, Ichihara S, Facca S, Hidalgo Diaz JJ (2016) Outcomes of minimally invasive plate osteosynthesis (MIPO) with volar locking plates in distal radius fractures: a review. Hand Surg Rehabil. 35S:S80–S85
doi: 10.1016/j.hansur.2016.02.011
Tang JB, Giddins G (2016) Why and how to report surgeons’ levels of expertise. J Hand Surg Eur 41:365–366
doi: 10.1177/1753193416641590
Franceschi F, Franceschetti E, Paciotti M, Cancilleri F, Maffulli N, Denaro V (2015) Volar locking plates versus K-wire/pin fixation for the treatment of distal radial fractures: a systematic review and quantitative synthesis. Br Med Bull 115:91–110
doi: 10.1093/bmb/ldv015
Loisel F, Bourgeois M, Rondot T, Nallet J, Boeckstins M, Rochet S et al (2018) Treatment goals for distal radius fractures in 2018: recommendations and practical advice. Eur J Orthop Surg Traumatol 28:1465–1468
doi: 10.1007/s00590-018-2196-9
Zenke Y, Sakai A, Oshige T, Moritani S, Fuse Y, Maehara T et al (2011) Clinical results of volar locking plate for distal radius fractures: conventional versus minimally invasive plate osteosynthesis. J Orthop Trauma 25:425–431
doi: 10.1097/BOT.0b013e3182008c83
Rey PB, Rochet S, Loisel F, Obert L (2014) Technical note: how to spare the pronator quadratus during MIPO of distal radius fractures by using a mini-volar plate. Chir Main 33:95–99
doi: 10.1016/j.main.2013.12.006
Loisel F, Kielwasser H, Faivre G, Rondot T, Rochet S, Adam A et al (2018) Treatment of distal radius fractures with locking plates: an update. Eur J Orthop Surg Traumatol 28:1537–1542
doi: 10.1007/s00590-018-2274-z
Guillou J, Darees M, Pougès C, Christiaens N, Guerre E, Chantelot C (2019) What happens to the posterior comminution in extra-articular fractures of the distal radius treated with volar locking plates? Hand Surg Rehabil. 38:91–96
doi: 10.1016/j.hansur.2018.10.238
Barbier O, Obert L (2019) Distal radius fracture: the right treatment for each patient. Orthop Traumatol Surg Res. 105:403–405
doi: 10.1016/j.otsr.2019.02.007
Miyashima Y, Kaneshiro Y, Yano K, Teraura H, Sakanaka H, Uemura T (2019) Size and stabilization of the dorsoulnar fragment in AO C3-type distal radius fractures. Injury 50:2004–2008
doi: 10.1016/j.injury.2019.08.003
Soong M, Earp BE, Bishop G, Leung A, Blazar P (2011) Volar locking plate implant prominence and flexor tendon rupture. J Bone Joint Surg Am 93:328–335
doi: 10.2106/JBJS.J.00193
Zemirline A, Naito K, Lebailly F, Facca S, Liverneaux P (2014) Distal radius fixation through a mini-invasive approach of 15 mm. Part 1: feasibility study. Eur J Orthop Surg Traumatol 24:1031–1037
doi: 10.1007/s00590-013-1364-1
Jo YH, Kim K, Lee BG, Kim JH, Lee CH, Lee KH (2019) Incidence of and risk factors for complex regional pain syndrome type 1 after surgery for distal radius fractures: a population-based study. Sci Rep. 9:4871
doi: 10.1038/s41598-019-41152-x
Rupp M, Cambon-Binder A, Alt V, Feron JM (2019) Is percutaneous pinning an outdated technique for distal radius fractures? Injury 50(Suppl):S30–S35
doi: 10.1016/j.injury.2019.03.048
Bruyere A, Vernet P, Botero SS, Igeta Y, Hidalgo Diaz JJ, Liverneaux P (2018) Conservative treatment of distal fractures after the age of 65: a review of literature. Eur J Orthop Surg Traumatol 28:1469–1475
doi: 10.1007/s00590-018-2150-x
Dario P, Matteo G, Carolina C, Marco G, Cristina D, Daniele F et al (2014) Is it really necessary to restore radial anatomic parameters after distal radius fractures? Injury 45(Suppl 6):S21–S26
pubmed: 25457314
Costa ML, Achten J, Rangan A, Lamb SE, Parsons NR (2019) Percutaneous fixation with Kirschner wires versus volar locking-plate fixation in adults with dorsally displaced fracture of distal radius: five-year follow-up of a randomized controlled trial. Bone Joint J. 101:978–983
doi: 10.1302/0301-620X.101B8.BJJ-2018-1285.R1
Chaudhry H, Kleinlugtenbelt YV, Mundi R, Ristevski B, Goslings JC, Bhandari M (2015) Are volar locking plates superior to percutaneous K-wires for distal radius fractures? A meta-analysis. Clin Orthop Relat Res 473:3017–3027
doi: 10.1007/s11999-015-4347-1
Takada N, Otsuka T, Yamada K, Suzuki H, Hasuo T, Kondo A et al (2012) Minimally invasive plate osteosynthesis for distal radius fractures with a palmar locking plate. Eur J Trauma Emerg Surg 38:627–632
doi: 10.1007/s00068-012-0204-z
Neubauer T, Plecko M, Grechenig S, Hartmann A, Ortmaier R, Hitzl W, Feigl G (2019) Minimal invasive plating of distal radius fractures. A safe procedure? Ann Anat. 224:172–178
doi: 10.1016/j.aanat.2019.05.001
Gordon KD, Pardo RD, Johnson JA, King GJ, Miller TA (2004) Electromyographic activity and strength during maximum isometric pronation and supination efforts in healthy adults. J Orthop Res 22:208–213
doi: 10.1016/S0736-0266(03)00115-3
Cannon TA, Carlston CV, Stevanovic MV, Ghiassi AD (2014) Pronator-sparing technique for volar plating of distal radius fractures. J Hand Surg Am. 39:2506–2511
doi: 10.1016/j.jhsa.2014.09.011
Häberle S, Sandmann GH, Deiler S, Kraus TM, Fensky F, Torsiglieri T et al (2015) Pronator quadratus repair after volar plating of distal radius fractures or not? Results of a prospective randomized trial. Eur J Med Res. 20:93
doi: 10.1186/s40001-015-0187-4
Mulders MAM, Walenkamp MMJ, Bos FJME, Schep NWL, Goslings JC (2017) Repair of the pronator quadratus after volar plate fixation in distal radius fractures: a systematic review. Strategies Trauma Limb Reconstr. 12:181–188
doi: 10.1007/s11751-017-0288-4
Agee JM (1994) Application of multiplanar ligamentotaxis to external fixation of distal radius fractures. Iowa Orthop J 14:31–37
pubmed: 7719775
pmcid: 2329043
Lee DY, Park YJ, Park JS (2019) A meta-analysis of studies of volar locking plate fixation of distal radius fractures: conventional versus minimally invasive plate osteosynthesis. Clin Orthop Surg 11:208–219
doi: 10.4055/cios.2019.11.2.208