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J Wrist Surg 2023; 12(05): 384-389
DOI: 10.1055/s-0043-1760736
Special Review Article

A Stepwise Intraoperative Protocol to Minimize Complications after Volar Plating

Chul Ki Goorens
1   Department of Orthopaedics and Traumatology, Regionaal Ziekenhuis Tienen, Kliniekstraat, Tienen, Belgium
,
Gilles Van Eetvelde
1   Department of Orthopaedics and Traumatology, Regionaal Ziekenhuis Tienen, Kliniekstraat, Tienen, Belgium
2   Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan, Brussels, Belgium
,
Niels Debaenst
2   Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan, Brussels, Belgium
,
Kjell Van Royen
2   Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan, Brussels, Belgium
3   Department of Orthopaedics and Traumatology, OLV Aalst, Moorselbaan, Aalst, Belgium
› Institutsangaben Funding No external funding received for this project.
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Abstract

Background Although outcome of volar plating is generally good, care should be taken to avoid specific iatrogenic and preventable complications, with an incidence reporting averaging 15%. Flexor tendon rupture due to a prominent plate, extensor tendon rupture due to a dorsal protruding screw tips, cartilage lesions due to intra-articular screw placement, loss of reduction due to insufficient stability, and persisting ulnar pain with distal radioulnar joint instability due to unstable triangular fibrocartilaginous complex lesions or unstable ulnar styloid base fractures all have been described.

Purpose We believe that a majority of these complications can be prevented by meticulous assessment of several intraoperative parameters during volar plating. Therefore, we introduce the WRIST protocol, a stepwise easy-to-remember manual that combines multiple fluoroscopic measurements to guide intraoperative decision making.

Conclusion Large prospective studies of the “WRIST” protocol are needed for validation. But we believe that it may help surgeons to optimize surgical technique, functional and radiographic outcome, and prevent complications when treating distal radial fractures.

Keywords

distal radial fracture - volar plate - protocol - complications

Authors' Contributions

- Conception of the protocol: C.K.G.

  - Testing and reviewing of the protocol during surgery: C.K.G., G.V.E., N.D., K.V.R.

  - Main writer of manuscript: C.K.G.

  - Assisting writers of manuscript: G.V.E., N.D., K.V.R.

  - Review of the submission: C.K.G., G.V.E., N.D.

  All authors have met the ICMJE criteria for authorship.




Publikationsverlauf

Eingereicht: 11. Oktober 2022

Angenommen: 28. November 2022

Artikel online veröffentlicht:
09. Februar 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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