Subscribe to RSS
DOI: 10.1055/s-0039-1685544
A Survey of the Median Nerve Elasticity after Volar Locking Plate Fixation Using Ultrasound Elastography
![](https://www.thieme-connect.de/media/10.1055-s-00031417/202002/lookinside/thumbnails/10-1055-s-0039-1685544_00045-1.jpg)
Abstract
Introduction Median nerve disorder is one of the complications after surgery using volar locking plate (VLP) for distal radius fracture (DRF). In this study, elasticity of the median nerve was quantified using ultrasound elastography (EG) (real-time tissue EG) and compared between the operation and healthy sides in patients after surgery for DRF using VLP.
Materials and Methods The subjects of this study were 28 patients (4 males and 24 females; mean age: 58.5 years) who could be followed up for more than 6 months after surgery for DRF and were able to be examined by EG. We evaluated median nerve elasticities on the operation and healthy sides using EG on the final follow-up.
Results The median nerve strain ratios were 3.97 ± 2.99 on the operation side and 3.91 ± 1.51 on the healthy side, showing no significant difference in elasticity of the median nerve between the operation and healthy sides.
Conclusion Median nerve disorder, which is a complication after surgery with VLP, can be objectively detected using EG capable of evaluating median nerve elasticity externally to detect medial nerve degeneration while degeneration of the median nerve. Thus, EG may be used as a useful diagnostic tool to prevent complications and decide on appropriate timing of VLP extraction.
Keywords
elastography - distal radius fractures - median nerve - volar locking plate - complications - carpal tunnel syndromePublication History
Article published online:
23 April 2019
© .
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
-
References
- 1 Thorninger R, Madsen ML, Wæver D, Borris LC, Rölfing JHD. Complications of volar locking plating of distal radius fractures in 576 patients with 3.2 years follow-up. Injury 2017; 48 (06) 1104-1109
- 2 Ho AW, Ho ST, Koo SC, Wong KH. Hand numbness and carpal tunnel syndrome after volar plating of distal radius fracture. Hand (N Y) 2011; 6 (01) 34-38
- 3 Johnson NA, Cutler L, Dias JJ, Ullah AS, Wildin CJ, Bhowal B. Complications after volar locking plate fixation of distal radius fractures. Injury 2014; 45 (03) 528-533
- 4 Fuller DA, Barrett M, Marburger RK, Hirsch R. Carpal canal pressures after volar plating of distal radius fractures. J Hand Surg [Br] 2006; 31 (02) 236-239
- 5 Miyamoto H, Halpern EJ, Kastlunger M. et al. Carpal tunnel syndrome: diagnosis by means of median nerve elasticity—improved diagnostic accuracy of US with sonoelastography. Radiology 2014; 270 (02) 481-486
- 6 Faul F, Erdfelder E, Lang AG, Buchner A. G* power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007; 39 (02) 175-191
- 7 Chung KC, Watt AJ, Kotsis SV, Margaliot Z, Haase SC, Kim HM. Treatment of unstable distal radial fractures with the volar locking plating system. J Bone Joint Surg Am 2006; 88 (12) 2687-2694
- 8 Diaz-Garcia RJ, Oda T, Shauver MJ, Chung KC. A systematic review of outcomes and complications of treating unstable distal radius fractures in the elderly. J Hand Surg Am 2011; 36 (05) 824-35.e2
- 9 Arora R, Lutz M, Hennerbichler A, Krappinger D, Espen D, Gabl M. Complications following internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma 2007; 21 (05) 316-322
- 10 Ghajarzadeh M, Dadgostar M, Sarraf P, Emami-Razavi SZ, Miri S, Malek M. Application of ultrasound elastography for determining carpal tunnel syndrome severity. Jpn J Radiol 2015; 33 (05) 273-278
- 11 Okutsu I, Ninomiya S, Yoshida A, Hamanaka I, Kitajima I. Measurement of carpal canal and median nerve pressure in patients with carpal tunnel syndrome. Tech Hand Up Extrem Surg 2004; 8 (02) 124-128
- 12 Gwathmey Jr FW, Brunton LM, Pensy RA, Chhabra AB. Volar plate osteosynthesis of distal radius fractures with concurrent prophylactic carpal tunnel release using a hybrid flexor carpi radialis approach. J Hand Surg Am 2010; 35 (07) 1082-1088
- 13 Nourbakhsh A, Tan V. Median nerve fibrosis at the distal forearm after volar plate fixation of distal radius fracture. J Hand Surg Eur Vol 2010; 35 (09) 768-769
- 14 Wang J, Zhang L, Ma J, Yang Y, Jia H, Ma X. Is intramedullary nailing better than the use of volar locking plates for fractures of the distal radius?. A meta-analysis of randomized controlled trials. J Hand Surg Eur Vol 2016; 41 (05) 543-552
- 15 Lattmann T, Dietrich M, Meier C, Kilgus M, Platz A. Comparison of 2 surgical approaches for volar locking plate osteosynthesis of the distal radius. J Hand Surg Am 2008; 33 (07) 1135-1143
- 16 Fan J, Jiang B, Wang B. et al. Analysis of soft-tissue complications of volar plate fixation for managing distal radius fractures and clinical effect while preserving pronator quadratus. Acta Orthop Belg 2016; 82 (02) 305-312
- 17 Soong M, Earp BE, Bishop G, Leung A, Blazar P. Volar locking plate implant prominence and flexor tendon rupture. J Bone Joint Surg Am 2011; 93 (04) 328-335