[The VB system: a new modular osteosynthesis material involving both screws and wires]

Prospective continuous study comparing intrafocal cross-pinning HK2(®) with a locking plate in distal radius fracture fixation

The fixation of distal radius fractures by pinning or locking plates remains controversial. The aim of this prospective continuous study was to compare the results of 28 anterior locking plates with 23 intrafocal cross-pinning HK2(®) systems. The mean age of group I (SVP(®), SBI™ plate) was 61 years. There were 15 extra-articular and 13 articular fractures. The mean age of group II (HK2(®), Arex™) was 63 years, with 13 extra-articular and 10 articular fractures. Twelve clinical variables were measured: pain, wrist strength, supination strength, pronation strength, quick DASH score, range of wrist motion in flexion, extension, pronation, and supination, ulnar variance, radial slope, and radial volar tilt. At 40 weeks follow-up, there was no difference between the two groups for 10 variables; two variables showed differences between the two groups: mean quick DASH score was 10.7 for group I, 19.7 for group II, and mean ulnar variance was -0.95 mm for group I, and 1.16 mm for group II. Six transient complications were noted for group I: five tenosynovitis, and one carpal tunnel syndrome. We noted 12 complications in group II: four superficial infections, two secondary displacements, one pin migration, two CRPS type II, two tendon ruptures and one nerve irritation. Generally, plates provided a more stable fixation associated with less complications while the HK2(®) system was quicker and less costly. The indications for its use need to be refined with a larger series and longer follow-up.

Traitement chirurgical des fractures du capitellum chez l'adulte. À propos de huit cas

Fracture of the capitellum is a rare intra-articular fracture and presents a frontal fracture line. It occurs in adolescents after the age of 13 years and in adults. We report a series of eight patients treated between 1992 and 2002. There were five females and three males with a mean age of 25 years (range: 20-34 years). According to the classification of Bryan and Morrey, three fractures were classified as type I, three as type II and two as type III. All patients were operated on within the first week after injury. The fixation techniques used were screw fixation in five cases and Kirschner wire fixation in three cases. Seven patients had excellent results and one patient had some limitation of range of movement. There were no instances of infection or avascular necrosis. Diagnosis of this fracture is often missed. Poor results of treatment are observed after imperfect reduction, delayed treatment or resection of the capitellum. We report in this study the results of surgical treatment.