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Archives of Orthopaedic and Trauma Surgery

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01-06-2018 | Handsurgery

Comparison of volarly and dorsally displaced distal radius fracture treated by volar locking plate fixation

Authors: S. Erhart, S. Toth, P. Kaiser, T. Kastenberger, C. Deml, R. Arora

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 6/2018

Abstract

Introduction

In case of distal radius fractures (DRF) the distal fragment generally displaces either dorsally or volarly. Scientific literature however, seldom differentiates between volarly and dorsally displaced DRFs when reporting results. It is no clear, if the direction of displacement has an influence on the clinical and radiological outcome. This study was intended to evaluate the influence of displacement direction in adult patients with surgically treated Colles or Smith type fractures.

Patients and methods

After a mean follow up (FU) time of above 5 years, 50 patients who underwent open reduction and internal fixation for DRFs (25 Smith type fractures, 25 Colles type fractures) were included. Upon FU, standard X-rays and a clinical evaluation as well as evaluation scores were raised and analysed.

Results

Clinical evaluation showed no difference between the Colles and the Smith group. Radiologic and clinical results for the Colles group showed diminished flexion compared to the healthy wrist, decreased radial inclination and dorsal tilt during FU and progression of osteoarthritis. For the Smith group decreased grip strength compared to the healthy wrist and osteoarthritis-progression was found. For both groups there was no correlation between radiologic values, grip strength, arthrosis grading, disability of arm, shoulder and hand score and patient rated wrist evaluation score.

Discussion

Decreased flexion in combination with a decreased dorsopalmar tilt might hint towards a mechanical inhibition in the Colles group. Altogether, the study showed good clinical outcome with satisfactory radiological result. As all patients showed arthrosis progression, the fracture per se is to be seen as a prearthrotic factor. It still remains unclear which measures could be taken to prevent this.

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Title: Comparison of volarly and dorsally displaced distal radius fracture treated by volar locking plate fixation
Authors: S. Erhart
S. Toth
P. Kaiser
T. Kastenberger
C. Deml
R. Arora
Publication date: 01-06-2018
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 6/2018
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-018-2925-x

At a glance: The STEP trials

Springer Medicine

Comparison of volarly and dorsally displaced distal radius fracture treated by volar locking plate fixation

Abstract

Introduction

Patients and methods

Results

Discussion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Patients and methods

Results

Discussion

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