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European Journal of Trauma and Emergency Surgery

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01-12-2021 | Distal Radius Fracture | Original Article

Using mini-arthrotomy for dorsal plating to treat intraarticular distal radius fractures: can it improve radiological and clinical outcomes?

Authors: Annika Müller, Christopher Child, Florin Allemann, Hans-Christoph Pape, Philipe Breiding, Florian Hess

Published in: European Journal of Trauma and Emergency Surgery | Issue 6/2021

Abstract

Purpose

Using palmar plating to treat complex intraarticular distal radius fractures is standard of care. However, fracture fragments can also be managed using a dorsal approach with arthrotomy, which is useful when treating fractures involving the dorsal joint aspect. We compared radiological and clinical outcomes after dorsal plating with or without an intraoperative arthrotomy.

Methods

31 of the 359 patients with a distal radius fracture had an AO Type 2R3 C3 fracture surgically treated using a dorsal approach (01/2015–10/2018). Fractures other than C3 were excluded from this analysis. Group 1 (n = 14) had no arthrotomy, Group 2 (n = 17) underwent intraoperative dorsal mini-arthrotomy. Clinical results were measured by range of motion (ROM), Patient-rated wrist evaluation (PRWE) and Disabilities of arm, shoulder and hand (DASH) scores. Radiological results were evaluated using the AO scoring system.

Results

ROM, DASH and PRWE did not differ significantly between groups. Joint surface restoration was insufficient in five patients in Group 1 (p = 0.05). A trend towards better radiological results, although not statistically significant, was noted in Group 2 (p = 0.06). Plate removal was performed in 12 patients due to limited ROM (6 patients in each group). One patient (Group 2) with chronic pain and step off in the joint line underwent corrective osteotomy.

Conclusions

We did not detect a difference in patient outcomes using the dorsal longitudinal mini-arthrotomy; however, it may prevent incongruent joint reconstruction since all cases occurred in Group 1. In the absence of intraoperative CT scan, longitudinal mini-arthrotomy may be used to enhance visualization and achieve joint surface reconstruction.

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Title: Using mini-arthrotomy for dorsal plating to treat intraarticular distal radius fractures: can it improve radiological and clinical outcomes?
Authors: Annika Müller
Christopher Child
Florin Allemann
Hans-Christoph Pape
Philipe Breiding
Florian Hess
Publication date: 01-12-2021
Publisher: Springer Berlin Heidelberg
Keyword: Distal Radius Fracture
Published in: European Journal of Trauma and Emergency Surgery / Issue 6/2021
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-020-01354-9

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Springer Medicine

Using mini-arthrotomy for dorsal plating to treat intraarticular distal radius fractures: can it improve radiological and clinical outcomes?

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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