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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2013 June;64(3):293-304
Surgical treatment of unstable distal radius fractures with locking volar plates: comparison between radiographic outcomes and functional results
Casale V., Agati G., Massè A., Schirò M., Violante E., Drogo N., D’amelio A. ✉
Struttura Complessa Dipartimento Universitario di Ortopedia e Traumatologia, Azienda Ospedaliero-Universitaria San Luigi Gonzaga, Orbassano, Torino, Italia
Aim: The purpose of this study was to correlate the clinical results obtained with the radiographic findings after surgery for internal fixation of fractures of the wrist joint. We wanted to seek to restore the anatomical features with particular precision to the most influential ones on functional recovery.
Methods: Fifty patients with articular wrist fractures (AO classification Foundation: A2, A3, B3, C2 and C3) treated with internal fixation with a volar plate with angular stability, operated between 2008 and 2011 at the San Luigi Gonzaga AOU Orbassano, between 19 and 85 years old. We used Aptus Radius (Medartis®) volar plates. Mean postoperative immobilization was 18 days. Mean follow-up was 23 months. Patients were all clinically evaluated using the Mayo Wrist Score. Radiographically we calculated the distal radial volar tilt angle, the radial deviation angle, the radial length and the ulnar variance.
Results: Clinically, the results were satisfactory. The ideal immobilization time for a better recovery was from 14 to 21 days. Among the associated fractures of the ulnar styloid, patients who were not treated with surgery functionally recovered less than those who underwent additional surgical treatment.
Conclusion: A careful reduction of distal radius fracture and a stable osteosynthesis are the first goal of surgical treatment of wrist fractures. Restoring the anatomical integrity of DRUJ and reduction with synthesis of eventual fracture of the ulnar styloid are also important goals to search for the best functional recovery.