TREATMENT OF TYPE C FRACTURES OF THE DISTAL RADIUS WITH VOLAR LOCKING COMPRESSION PLATE AND RADIAL STYLOID PROCESS PLATE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Jun , YIN Weizhong , SHEN Yanguo , DING Juhong , Qin Huimin , CAO Shifeng , HU Xiaoliang.

Department of Orthopaedics, Shanghai Pudong New Area People’s Hospital, Shanghai, 201299, P.R.China. Corresponding author: ZHANG Jun, E-mail: backnsyncwest@sohu.com;

Corresponding author：

Keywords：

Fracture of distal radius; Locking compression plate; Internal fixation

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Objective To analyze the effectiveness of volar locking compression plate (LCP) and radial styloid process plate for the treatment of type C fractures of the distal radius. Methods Between May 2010 and May 2011, 24 cases of type C fractures of the distal radius were treated, including 8 males and 16 females with an average age of 52 years (range, 23-73 years). Injury was caused by falling in 20 cases and by traffic accident in 4 cases. All were fresh closed fractures. The locations were the left side in 15 cases and the right side in 9 cases. According to AO typing, there were 16 cases of type C2 and 8 cases of type C3. The preoperative palmar tilt angle ranged from — 60 to 25° (mean, — 45.3°); the preoperative ulnar inclination angle ranged from — 16 to 13° (mean, 8.2°); and the preoperative radial length shortening was 8-18 mm (mean, 12 mm). The time from injury to operation was 3-10 days (mean, 5.2 days). Results All operation incisions healed primarily. All patients were followed up 9-16 months (mean, 13.5 months). The healing time of fracture was 8-12 weeks (mean, 10.2 weeks). The articular surface was smooth and the radial length was recovered. The postoperative palmar tilt angle ranged from 8 to 15° (mean, 12.3°); the postoperative ulnar inclination angle ranged from 18 to 26° (mean, 22.3°). No loss of reduction, refracture, or carpal tunnel syndrome occurred during follow-up. The average range of motion of the wrist was 45.3° (range, 30-70°) in dorsal extension, was 50.2° (range, 26-78°) in palmar flexion, was 13.5° (range, 8-25°) in radial inclination, was 23.6° (range, 15-32°) in ulnar inclination, was 65.7° (range, 35-90°) in pronation, and was 72.5° (range, 20-90°) in supination at last follow-up. According to the wrist function by Gartland-Werley scoring, the results were excellent in 12 cases, good in 8 cases, and fair in 4 cases; and the excellent and good rate was 83.3%. Conclusion Treatment of type C fractures of the distal radius with volar LCP and radial styloid process plate can reconstruct normal anatomic structures and get good functional recovery.

Citation： ZHANG Jun,YIN Weizhong,SHEN Yanguo,DING Juhong,Qin Huimin,CAO Shifeng,HU Xiaoliang.. TREATMENT OF TYPE C FRACTURES OF THE DISTAL RADIUS WITH VOLAR LOCKING COMPRESSION PLATE AND RADIAL STYLOID PROCESS PLATE. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(11): 1281-1284. doi: Copy

1.	姜保国, 张殿英, 傅中国, 等. 桡骨远端粉碎性骨折及关节内骨折的手术治疗. 中华骨科杂志, 2002, 22(2): 80-83.
2.	张殿英, 姜保国, 傅中国, 等. 斜T形锁定加压接骨板治疗桡骨远端骨折的临床研究. 中华手外科杂志, 2004, 20(1): 24-26.
3.	Arora R, Lutz M, Fritz D, et al. Palmar locking plate for treatment of unstable dorsal dislocated distal radius fractures. Arch Orthop Trauma Surg, 2005, 125(6): 399-404.
4.	Geller L, Bernstein M, Carli A, et al. Efficacy of different fixation devices in maitaining an initial reduction for surgically managed distal radius fractures. Can J Surg, 2009, 52(5): E161-166.
5.	Gartland JJ Jr, Werley CW. Evaluation of healed Colles’fractures. J Bone Joint Surg (Am), 1951, 33-A(4): 895-907.
6.	Koshimune M, Kamano K, Takamatsu K, et al. A randomized comparison of locking and non-locking palmar plating for unstable colles’fractures in the elderly. J Hand Surg (Br), 2005, 30(5): 499-503.
7.	白志刚, 聂继平, 李昶, 等. 不稳定桡骨远端骨折的手术治疗. 中华手外科杂志, 2010, 26(2): 76-78.
8.	Prommersberger KJ, Lanz UB. Corrective osteotomy of the distal radius through volar approach. Tech Hand Up Extrem Surg, 2004, 8(2): 70-77.
9.	姜保国, 张殿英, 付中国, 等. 桡骨远端骨折的治疗建议. 中华创伤骨科杂志, 2010, 12(11): 1053-1056.
10.	李夏, 高伟, 王秋根, 等. AO新型锁定内固定系统治疗不稳定型桡骨远端骨折的疗效观察. 中华创伤骨科杂志, 2010, 12(1): 6-10.
11.	刘兆杰, 张银光, 胡永成. 锁定加压钢板治疗不稳定型桡骨远端骨折. 中华创伤杂志, 2011, 27(8): 698-702.
12.	何纯青, 许猛, 张群, 等. 桡背侧双锁定钢板治疗桡骨远端不稳定骨折. 中华创伤骨科杂志, 2011, 13(3): 230-233.
13.	张殿英, 傅中国, 王天兵, 等. 两种内固定方法治疗桡骨远端骨折的疗效比较研究. 中华手外科杂志, 2010, 26(6): 340-343.
14.	Keast-Butler O, Schemitsch EH. Biology versus mechanics in the treatment of distal radial fractures. J Orthop Trauma, 2008, 22(8 Suppl): S91-95．.
15.	周野, 王德, 李红林. 掌侧锁定加压钢板治疗老年桡骨远端关节内骨折. 中国修复重建外科杂志, 2008, 22(6): 759-760.
16.	Miller DL, Goswami T. A review of locking compression plate biomechanics and their advantages as internal fixators in fracture healing. Clin Biomech (Bristol, Avon), 2007 , 2(10): 1049-1062.
17.	Rikli DA, Regazzoni P. Fractures of the distal end of the radius treated by internal fixation and early function. A preliminary report of 20 cases. J Bone Joint Surg (Br), 1996, 78(4): 588-592.
18.	Wong KK, Chan KW, Kwok TK, et al. Volar fixation of dorsally displaced distal radial fracture using locking compression plate. J Orthop Surg (Hong Kong), 2005, 13(2): 153-157.
19.	Guofen C, Dot K, Hattnri Y, et al. Arthrosonpically assisted reduction and immobilization of intraarticular fracture of the distal end of the radius: several options of reduction and immobilization. Teeh Hand Up Extrem Surg, 2005, 9(2): 84-90.
20.	Ring D, Prommersberger K, Jupiter JB. Combined dorsal and volar plate fixation of complex fractures of the distal part of the radius. J Bone Joint Surg (Am), 2005, 87 Suppl 1(Pt 2): 195-212.
21.	唐昊, 王秋根, 张秋林, 等. 掌侧钢板固定治疗不稳定的背侧移位桡骨远端骨折. 中国矫形外科杂志, 2007, 15(22): 1681-1683.

1. 姜保国, 张殿英, 傅中国, 等. 桡骨远端粉碎性骨折及关节内骨折的手术治疗. 中华骨科杂志, 2002, 22(2): 80-83.
2. 张殿英, 姜保国, 傅中国, 等. 斜T形锁定加压接骨板治疗桡骨远端骨折的临床研究. 中华手外科杂志, 2004, 20(1): 24-26.
3. Arora R, Lutz M, Fritz D, et al. Palmar locking plate for treatment of unstable dorsal dislocated distal radius fractures. Arch Orthop Trauma Surg, 2005, 125(6): 399-404.
4. Geller L, Bernstein M, Carli A, et al. Efficacy of different fixation devices in maitaining an initial reduction for surgically managed distal radius fractures. Can J Surg, 2009, 52(5): E161-166.
5. Gartland JJ Jr, Werley CW. Evaluation of healed Colles’fractures. J Bone Joint Surg (Am), 1951, 33-A(4): 895-907.
6. Koshimune M, Kamano K, Takamatsu K, et al. A randomized comparison of locking and non-locking palmar plating for unstable colles’fractures in the elderly. J Hand Surg (Br), 2005, 30(5): 499-503.
7. 白志刚, 聂继平, 李昶, 等. 不稳定桡骨远端骨折的手术治疗. 中华手外科杂志, 2010, 26(2): 76-78.
8. Prommersberger KJ, Lanz UB. Corrective osteotomy of the distal radius through volar approach. Tech Hand Up Extrem Surg, 2004, 8(2): 70-77.
9. 姜保国, 张殿英, 付中国, 等. 桡骨远端骨折的治疗建议. 中华创伤骨科杂志, 2010, 12(11): 1053-1056.
10. 李夏, 高伟, 王秋根, 等. AO新型锁定内固定系统治疗不稳定型桡骨远端骨折的疗效观察. 中华创伤骨科杂志, 2010, 12(1): 6-10.
11. 刘兆杰, 张银光, 胡永成. 锁定加压钢板治疗不稳定型桡骨远端骨折. 中华创伤杂志, 2011, 27(8): 698-702.
12. 何纯青, 许猛, 张群, 等. 桡背侧双锁定钢板治疗桡骨远端不稳定骨折. 中华创伤骨科杂志, 2011, 13(3): 230-233.
13. 张殿英, 傅中国, 王天兵, 等. 两种内固定方法治疗桡骨远端骨折的疗效比较研究. 中华手外科杂志, 2010, 26(6): 340-343.
14. Keast-Butler O, Schemitsch EH. Biology versus mechanics in the treatment of distal radial fractures. J Orthop Trauma, 2008, 22(8 Suppl): S91-95．.
15. 周野, 王德, 李红林. 掌侧锁定加压钢板治疗老年桡骨远端关节内骨折. 中国修复重建外科杂志, 2008, 22(6): 759-760.
16. Miller DL, Goswami T. A review of locking compression plate biomechanics and their advantages as internal fixators in fracture healing. Clin Biomech (Bristol, Avon), 2007 , 2(10): 1049-1062.
17. Rikli DA, Regazzoni P. Fractures of the distal end of the radius treated by internal fixation and early function. A preliminary report of 20 cases. J Bone Joint Surg (Br), 1996, 78(4): 588-592.
18. Wong KK, Chan KW, Kwok TK, et al. Volar fixation of dorsally displaced distal radial fracture using locking compression plate. J Orthop Surg (Hong Kong), 2005, 13(2): 153-157.
19. Guofen C, Dot K, Hattnri Y, et al. Arthrosonpically assisted reduction and immobilization of intraarticular fracture of the distal end of the radius: several options of reduction and immobilization. Teeh Hand Up Extrem Surg, 2005, 9(2): 84-90.
20. Ring D, Prommersberger K, Jupiter JB. Combined dorsal and volar plate fixation of complex fractures of the distal part of the radius. J Bone Joint Surg (Am), 2005, 87 Suppl 1(Pt 2): 195-212.
21. 唐昊, 王秋根, 张秋林, 等. 掌侧钢板固定治疗不稳定的背侧移位桡骨远端骨折. 中国矫形外科杂志, 2007, 15(22): 1681-1683.

Chinese Journal of Reparative and Reconstructive Surgery

TREATMENT OF TYPE C FRACTURES OF THE DISTAL RADIUS WITH VOLAR LOCKING COMPRESSION PLATE AND RADIAL STYLOID PROCESS PLATE

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