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Published in: Archives of Orthopaedic and Trauma Surgery 3/2015

01-03-2015 | Trauma Surgery

Clinical results of using minimally invasive long plate osteosynthesis versus conventional approach for extensive comminuted metadiaphyseal fractures of the radius

Authors: Chun-Yu Chen, Kai-Cheng Lin, Shan-Wei Yang, Jenn-Huei Renn, Yih-Wen Tarng

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 3/2015

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Abstract

Introduction

The minimally invasive plate osteosynthesis (MIPO) technique has been introduced recently. The extensive comminuted fractures of the distal radial metaphysis with diaphyseal involvement are probably good indications for MIPO technique because of less extensive dissection and soft-tissue stripping. The purpose of this retrospective study was to compare the clinical results of MIPO technique to those of conventional open reduction in extensive metadiaphyseal fractures of distal radius.

Materials and methods

Of 34 patients treated for comminuted metadiaphyseal fractures of the distal radius between June 2006 and May 2012, all the patients had extra-articular fractures. Twenty-one patients underwent MIPO technique and 13 underwent conventional open reduction with long periarticular locking plates system (Zimmer). Six patients in the MIPO group and three in the conventional group who had concomitant distal ulnar fractures or distal radioulnar joint (DRUJ) injury underwent plate osteosynthesis or Kirschner-wire fixation before radial fixation. Perioperative parameters and union time were recorded. Radiologic assessment, Mayo Wrist Score, and satisfaction scale were evaluated at the final follow-up.

Results

All fractures united without secondary procedures. Radiologic assessment, Mayo wrist score, and time to union showed no significant difference between the two groups, but the MIPO group had significantly smaller incision wound, higher satisfaction scale, and shorter operative time than did the conventional group.

Conclusions

MIPO is capable of achieving functional results as good as those of conventional open reduction, with a higher satisfaction scale, smaller incision, and shorter operative time. When MIPO intervention is planned, concurrent distal ulnar fracture or DRUJ injury should be repaired first, thus facilitating subsequent indirect reduction. For treating intra-articular fractures, anatomical reduction of the articular surface is more important, and the MIPO technique described here is not recommended.
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Metadata
Title
Clinical results of using minimally invasive long plate osteosynthesis versus conventional approach for extensive comminuted metadiaphyseal fractures of the radius
Authors
Chun-Yu Chen
Kai-Cheng Lin
Shan-Wei Yang
Jenn-Huei Renn
Yih-Wen Tarng
Publication date
01-03-2015
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 3/2015
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-015-2162-5

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