FIXATION OF FRACTURES OF THE DISTAL EXTREMITY OF THE RADIUS USING THE MODIFIED KAPANDJI TECHNIQUE: EVALUATION OF THE RADIOLOGICAL RESULTS

Analysis of the Clinical and Radiological Results of Bridge Plate Versus External Fixation in Comminuted Distal Radius Fractures

Objective  To evaluate and compare the clinical and radiological outcomes of patients with comminuted distal radius fractures treated with an external fixator or a dorsal bridge plate. Methods  In total, 45 patients were analyzed 1 year after surgery; 18 were treated with an external fixator, and 25 received a dorsal bridge plate. An analog pain scale and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire were applied, in addition to radiographic, strength and range of motion assessments. Statistical analyzes were performed using the chi-squared test and the Mann-Whitney non-parametric test. Results  Fractures were more common in women over 60 years old who suffered falls from their own height. Both methods demonstrated similar functional and radiological results. Infections were more prevalent in patients receiving external fixators, but their residual grip strength was better. Reflex sympathetic neuropathy was more common in subjects treated with a dorsal bridge plate. Conclusion  Our analysis showed no consensus on the superiority of one method over the other. Each method had advantages and disadvantages, but both led to good, similar outcomes. The treatment must be chosen according to the profile of the trauma, the patient's clinical conditions, the surgeon's experience, and the availability of materials.

Radiographic Evaluation of Patients Submitted to Percutaneous Fixation With Solid Screw for Distal Radius Fracture Treatment

Objective  The present paper aims to present results from radiographic evaluations of patients with extra-articular distal radius fractures submitted to percutaneous fixation with a 3.5 mm solid screw.

Methods  Analytical, descriptive and retrospective case series of 16 patients with evaluation of the radiographic parameters.

Results  The average age of the study population was 46.5 years old (25–60 years old); 81.25% of the sample was female. The average time until surgery was 8.8 days (4–14 days). The mean preprocedural volar tilt was - 7.41° (−23.48°–5.29°, standard deviation [SD] ± 6.59°). The mean volar tilt immediately after surgery was 5.93° (SD ± 6.23°, p  < 0.001). There was no statistical difference in volar tilt values after 6 months of follow-up. The mean preprocedural radial height was 4.13 mm (−7.8 mm–9.5 mm, SD ± 5.06 mm). There was a statistically significant increase at the immediate postoperative period to 10.04 mm ( p  = 0.002), and a significant reduction at 6 months to 9.55 mm ( p  = 0.012). The consolidation rate was 100% with the technique used, with a minimal complication rate. No patient had infection or required a reoperation.

Conclusion  The technique was effective for the treatment of distal radial extra-articular fractures at 6 months, with a low complication rate; radiographic parameters values were acceptable and close to the anatomical ones.