0
Surgical Techniques   |    
Combined Dorsal and Volar Plate Fixation of Complex Fractures of the Distal Part of the Radius
David Ring, MD1; Karl Prommersberger, MD2; Jesse B. Jupiter, MD1
1 Department of Orthopaedic Surgery, Massachusetts General Hospital, Yawkee Center, Suite 2100, 55 Fruit Street, Boston, MA 02114. E-mail address for D. Ring: dring@partners.org
2 Klinik fur Handchirurgie, Salzburger Leite 1, D97615 Bad Neustadt, Germany
View Disclosures and Other Information
In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from the AO Foundation (D.R. and J.B.J.). None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Investigation performed at Klinik fur Handchirurgie, Bad Neustadt, Germany, and Massachusetts General Hospital, Boston, Massachusetts
The original scientific article in which the surgical technique was presented was published in JBJS Vol. 86-A, pp. 1646-1652, August 2004

The Journal of Bone and Joint Surgery, Incorporated
JBJS Essential Surgical Techniques, 2005 Sep 01;87(1 suppl 2):195-212. doi: 10.2106/JBJS.E.00249
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case

Abstract

BACKGROUND:

Fractures of the distal part of the radius that are associated with complex comminution of both the articular surface and the metaphysis (subgroup C3.2 according to the Comprehensive Classification of Fractures) are a challenge for surgeons using standard operative techniques.

METHODS:

Twenty-five patients with subgroup-C3.2 fractures that had been treated with combined dorsal and volar plate fixation were evaluated at an average of twenty-six months after the injury. Subsequent procedures included implant removal in twenty-one patients and reconstruction of a ruptured tendon in two patients.

RESULTS:

An average of 54° of extension, 51° of flexion, 79° of pronation, and 74° of supination were achieved. The grip strength in the involved limb was an average of 78% of that in the contralateral limb. The average radiographic measurements were 2° of dorsal angulation, 21° of ulnar inclination, 0.8 mm of positive ulnar variance, and 0.7 mm of articular incongruity. Seven patients had radiographic signs of arthrosis during the follow-up period. A good or excellent functional result was achieved for twenty-four patients (96%) according to the rating system of Gartland and Werley and for ten patients (40%) according to the more stringent modified system of Green and O'Brien.

CONCLUSIONS:

Combined dorsal and volar plate fixation of the distal part of the radius can achieve a stable, mobile wrist in patients with very complex fractures. The results are limited by the severity of the injury and may deteriorate with longer follow-up. A second operation for implant removal is common, and there is a small risk of tendon-related complications.

Figures in this Article
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS Essential Surgical Techniques?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

     
    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org

    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe





    Related Content
    The Journal of Bone & Joint Surgery
    Results
    Provided by:
    Essential Surgical Techniques
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    03/26/2014
    Massachusetts - Boston University Orthopedic Surgical Associates
    04/16/2014
    Georgia - Choice Care Occupational Medicine & Orthopaedics
    06/29/2012
    PA - Thomas Jefferson University
    04/02/2014
    LA - Louisiana State University Health Sciences Center-Shreveport