RSS-Feed abonnieren
DOI: 10.1055/s-0040-1721141
Mini-Invasive Surgery for Distal Radius Fractures: A Double Incision under 12 mm
Abstract
Background Distal radius fracture is one of the most common lesions in adults. Surgical techniques have evolved considerably with a clear tendency toward mini-invasive techniques.
Objective Our aim is to push the limits to a 12 mm approach and evaluate its clinical and radiological results.
Patients and Methods Ten fractures in nine patients were operated by a double incision with mean size 11.50 ± 3.41 mm (range 8.00–1.00) and using a specially designed volar distal locking plate.
Results At the latest follow-up, visual analogue scale score for pain (0.20 ± 0.63 during rest and 0.60 ± 1.07 while making efforts) and quick DASH (quick Disabilities of the Arm, Shoulder and Hand) score (6.14 ± 7.43) were extremely low. All the range of motion parameters and grip strength were above the 95% barrier of the contralateral side, with exception of ulnar deviation. Radiological parameters obtained were located within the normal ranges. Time to return to independent daily tasks and work was 6.67 ± 5.15 and 10.14 ± 14.24 days, respectively. One case of transient carpal tunnel syndrome was solved with watchful waiting and one case of extensor tendons impingement was improved after plate removal. All patients were completely satisfied at the end of the treatment.
Conclusion In conclusion, mini-invasive volar technique for distal radius fractures with special designed plates in carefully selected patients allowed us to obtain good clinical and radiological results, minimal complications, fast recovery, and high-satisfactory rates.
Level of Evidence This is a Level IV, case series study.
Note
The study was performed at Beneficência Portuguesa de São Paulo, São Paulo, Brazil.
Ethical Approval
The current study took place after revision and approval by Ethical in Research Committee of Beneficência Portuguesa de São Paulo, São Paulo, Brazil.
Publikationsverlauf
Eingereicht: 17. August 2020
Angenommen: 15. Oktober 2020
Artikel online veröffentlicht:
04. Dezember 2020
© 2020. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Abe Y, Yoshida K, Tominaga Y. Less invasive surgery with wrist arthroscopy for distal radius fracture. J Orthop Sci 2013; 18 (03) 398-404
- 2 Wei XM, Sun ZZ, Rui YJ, Song XJ. Minimally invasive plate osteosynthesis for distal radius fractures. Indian J Orthop 2014; 48 (01) 20-24
- 3 Mauck BM, Swigler CW. Evidence-based review of distal radius fractures. Orthop Clin North Am 2018; 49 (02) 211-222
- 4 Zemirline A, Taleb C, Facca S, Liverneaux P. Minimally invasive surgery of distal radius fractures: a series of 20 cases using a 15 mm anterior approach and arthroscopy. Chir Main 2014; 33 (04) 263-271
- 5 Orbay J. Volar plate fixation of distal radius fractures. Hand Clin 2005; 21 (03) 347-354
- 6 Ruggiero GM. Saving tendons on distal radius fractures: a simple surgical pearl to prevent FPL tendon conflict with volar locking plates. J Wrist Surg 2017; 6 (03) 248-250
- 7 Zemirline A, Naito K, Lebailly F, Facca S, Liverneaux P. Distal radius fixation through a mini-invasive approach of 15 mm. Part 1: feasibility study. Eur J Orthop Surg Traumatol 2014; 24 (06) 1031-1037
- 8 Imatani J, Noda T, Morito Y, Sato T, Hashizume H, Inoue H. Minimally invasive plate osteosynthesis for comminuted fractures of the metaphysis of the radius. J Hand Surg [Br] 2005; 30 (02) 220-225
- 9 Lebailly F, Zemirline A, Facca S, Gouzou S, Liverneaux P. Distal radius fixation through a mini-invasive approach of 15 mm. PART 1: a series of 144 cases. Eur J Orthop Surg Traumatol 2014; 24 (06) 877-890
- 10 Liverneaux PA. The minimally invasive approach for distal radius fractures and malunions. J Hand Surg Eur Vol 2018; 43 (02) 121-130
- 11 Geissler WB, Fernandes D. Percutaneous and limited open reduction of intra-articular distal radial fractures. Hand Surg 2000; 5 (02) 85-92
- 12 Duncan SF, Weiland AJ. Minimally invasive reduction and osteosynthesis of articular fractures of the distal radius. Injury 2001; 32 (Suppl. 01) SA14-SA24
- 13 Sen MK, Strauss N, Harvey EJ. Minimally invasive plate osteosynthesis of distal radius fractures using a pronator sparing approach. Tech Hand Up Extrem Surg 2008; 12 (01) 2-6
- 14 Pire E, Hidalgo Diaz JJ, Salazar Botero S, Facca S, Liverneaux PA. Long volar plating for metadiaphyseal fractures of distal radius: study comparing minimally invasive plate osteosynthesis versus conventional approach. J Wrist Surg 2017; 6 (03) 227-234
- 15 Zhang X, Huang X, Shao X, Zhu H, Sun J, Wang X. A comparison of minimally invasive approach vs conventional approach for volar plating of distal radial fractures. Acta Orthop Traumatol Turc 2017; 51 (02) 110-117
- 16 Gutierrez Olivera N, Ruchelli L, Iglesias S, Capomassi M, Allende C. Minimally invasive plate osteosynthesis in distal radius fractures with metaphyseal extension: a series of 13 cases. Chir Main 2015; 34 (05) 227-233
- 17 Zenke Y, Sakai A, Oshige T. et al. Clinical results of volar locking plate for distal radius fractures: conventional versus minimally invasive plate osteosynthesis. J Orthop Trauma 2011; 25 (07) 425-431
- 18 Cannon TA, Carlston CV, Stevanovic MV, Ghiassi AD. Pronator-sparing technique for volar plating of distal radius fractures. J Hand Surg Am 2014; 39 (12) 2506-2511
- 19 Liverneaux P, Ichihara S, Facca S, Hidalgo Diaz JJ. Outcomes of minimally invasive plate osteosynthesis (MIPO) with volar locking plates in distal radius fractures: a review [in French]. Hand Surg Rehabil 2016; 35S: S80-S85
- 20 Galmiche C, Rodríguez GG, Xavier F, Igeta Y, Hidalgo Diaz JJ, Liverneaux P. Minimally invasive plate osteosynthesis for extra-articular distal radius fracture in postmenopausal women: longitudinal versus transverse incision. J Wrist Surg 2019; 8 (01) 18-23
- 21 Wei XM, Sun ZZ, Rui YJ, Song XJ, Jiang WM. Minimally invasive percutaneous plate osteosynthesis for distal radius fractures with long-segment metadiaphyseal comminution. Orthop Traumatol Surg Res 2016; 102 (03) 333-338
- 22 Rey PB, Rochet S, Loisel F, Obert L. Technical note: how to spare the pronator quadratus during MIPO of distal radius fractures by using a mini-volar plate. Chir Main 2014; 33 (02) 95-99