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HAND
Published in: HAND 4/2015

01-12-2015

Anatomic relationships in distal radius bridge plating: a cadaveric study

Authors: Jason Dahl, Daniel J. Lee, John C. Elfar

Published in: HAND | Issue 4/2015

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Abstract

Background

Two separate approaches have been described for radiocarpal spanning internal fixation for high-energy distal radius fractures with metaphyseal extension. To our knowledge, relevant anatomic relationships and structures at risk for iatrogenic injury have not been identified in the literature.

Methods

Twelve fresh frozen cadaver arms were randomized to fixation with a dorsal radiocarpal spanning plate using one of two techniques: (1) index finger metacarpal fixation (index group) or (2) middle finger metacarpal fixation (middle group). Cadaveric dissection and relevant anatomic relationships were assessed in relation to the plate.

Results

Superficial branches of the radial sensory nerve were in contact with the index group plate in all specimens, while no contact occurred in the middle group specimens. No extensor digitorum comminus (EDC) middle extensor tendons contacted the plate in the index group; an average of 10 cm of plate contact was seen in the middle group. The extensor pollicis longus (EPL) tendon contacted the plate in both the index and middle groups for an average distance of 12.4 and 25.5 mm, respectively. One complication [EPL and extensor indicis proprius (EIP) entrapment] was observed in the middle finger metacarpal group.

Conclusion

Mounting the dorsal bridge plate to the index finger metacarpal places the superficial branches of the radial sensory nerve at risk during dissection, while mounting the plate to the middle finger metacarpal leads to a greater degree of tendon-plate contact.
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Metadata
Title
Anatomic relationships in distal radius bridge plating: a cadaveric study
Authors
Jason Dahl
Daniel J. Lee
John C. Elfar
Publication date
01-12-2015
Publisher
Springer US
Published in
HAND / Issue 4/2015
Print ISSN: 1558-9447
Electronic ISSN: 1558-9455
DOI
https://doi.org/10.1007/s11552-015-9762-y

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