medigraphic.com
ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2025, Number 2

<< Back Next >>

Acta Ortop Mex 2025; 39 (2)

Radiographic measurements and secondary displacement in patients with open reduction and volar plate fixation of distal radius fractures

Martínez-Peniche J, Romo-Rodríguez R, Zamora-Muñoz P

Language: Spanish
References: 15
Page: 76-81
PDF size: 320.89 Kb.


ABSTRACT

Introduction: distal radius fractures are an important cause of disability in adults. Fracture displacement and malunion are known and common complications of treatment. Open reduction and fracture fixation with volar plates and screws restore the normal alignment of the radius, but there are few reports in the literature regarding secondary displacement of the fracture fragments. Objective: detect secondary displacement in patient receiving distal radius open reduction and internal fixation with volar plates in the last five years at a private third level hospital. Material and methods: a total of 54 patients satisfied our inclusion criteria. Radiographic measurements were taken on standard anteroposterior (AP) and lateral films, preoperative, immediate postoperative and six weeks postoperative. We considered significant displacement as follows: More than 5° of volar tilt or radial inclination change, and more than 1 mm displacement in ulnar variance or radial height. Results: all patients presented some degree of postoperative displacement, only seven patients were affected with displacement above our defined threshold. One patient displaced over acceptable reduction parameters. Statistical analysis with χ² test determined that female sex was the only significant risk factor for displacement in this study. Binary logistic regression analysis didn't find any significant risk factors. Conclusions: in these series, female sex was the only risk factor for postoperative displacement. This displacement probable is not clinically significant. Long term follow-up and increasing the number of patients can give more power to our evidence.


REFERENCES

  1. García-Lira F. Aspectos epidemiológicos y mecanismos de lesión de las fracturas de muñeca. Ortho-tips. 2011; 7(1): 6-13.

  2. Nellans KW, Kowalski E, Chung KC. The epidemiology of distal radius fractures. Hand Clin. 2012; 28(2): 113-25. doi: 10.1016/j.hcl.2012.02.001.

  3. Mallmin H, Ljunghall S. Incidence of Colles' fracture in Uppsala. A prospective study of a quarter-million population. Acta Orthop Scand. 1992; 63(2): 213-5. doi: 10.3109/17453679209154826.

  4. Chung KC, Spilson SV. The frequency and epidemiology of hand and forearm fractures in the United States. J Hand Surg Am. 2001; 26(5): 908-15. doi: 10.1053/jhsu.2001.26322.

  5. Carlos F, Clark P, Galindo-Suárez RM, Chico-Barba LG. Health care costs of osteopenia, osteoporosis, and fragility fractures in Mexico. Arch Osteoporos. 2013; 8: 125. doi: 10.1007/s11657-013-0125-4.

  6. Mulders MAM, van Eerten PV, Goslings JC, Schep NWL. Non-operative treatment of displaced distal radius fractures leads to acceptable functional outcomes, however at the expense of 40% subsequent surgeries. Orthop Traumatol Surg Res. 2017;103(6):905-909. doi: 10.1016/j.otsr.2017.01.017.

  7. Makhni EC, Ewald TJ, Kelly S, Day CS. Effect of patient age on the radiographic outcomes of distal radius fractures subject to nonoperative treatment. J Hand Surg Am. 2008; 33(8): 1301-8. doi: 10.1016/j.jhsa.2008.04.031.

  8. Delclaux S, Trang Pham TT, Bonnevialle N, Aprédoaei C, Rongières M, Bonnevialle P, Mansat P. Distal radius fracture malunion: Importance of managing injuries of the distal radio-ulnar joint. Orthop Traumatol Surg Res. 2016; 102(3): 327-32. doi: 10.1016/j.otsr.2015.12.010.

  9. Orbay J. Volar plate fixation of distal radius fractures. Hand Clin. 2005; 21(3): 347-54. doi: 10.1016/j.hcl.2005.02.003.

  10. Souer JS, Ring D, Jupiter J, Matschke S, Audigé L, Marent-Huber M, et al. Comparison of intra-articular simple compression and extra-articular distal radial fractures. J Bone Joint Surg Am. 2011; 93(22): 2093-9. doi: 10.2106/JBJS.J.01069.

  11. Hashimoto S, Yamazaki H, Hayashi M, Isobe F, Miyaoka S, Kitamura Y, et al. Radiographic change in articular reduction after volar locking plating for intra-articular distal radius fractures. J Hand Surg Am. 2020; 45(4): 335-40. doi: 10.1016/j.jhsa.2019.08.012.

  12. Neuhaus V, Badri O, Ferree S, Bot AG, Ring DC, Mudgal CS. Radiographic alignment of unstable distal radius fractures fixed with 1 or 2 rows of screws in volar locking plates. J Hand Surg Am. 2013; 38(2): 297-301. doi: 10.1016/j.jhsa.2012.10.040.

  13. Kreder HJ, Hanel DP, McKee M, Jupiter J, McGillivary G, Swiontkowski MF. X-ray film measurements for healed distal radius fractures. J Hand Surg Am. 1996; 21(1): 31-9. doi: 10.1016/S0363-5023(96)80151-1. Erratum in: J Hand Surg [Am]. 1996; 21(3): 532.

  14. American Academy of Orthopaedic Surgeons. The Treatment of Distal Radius Fractures: Guideline and Evidence Report. American Academy of Orthopaedic Surgeons. 2009. Disponible en: https://www.aaos.org/globalassets/quality-and-practice-resources/distal-radius/distal-radius-fractures-clinical-practice-guideline.pdf

  15. Blakeney WG. Stabilization and treatment of Colles' fractures in elderly patients. Clin Interv Aging. 2010; 5: 337-44. doi: 10.2147/CIA.S10042.



EVIDENCE LEVEL

II




2020     |     www.medigraphic.com