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Taha TA. The use of a laminar spreader for the reduction of extra-articular distal radius fractures: A technical trick. OTA Int 2023; 6:e263. [PMID: 37719316 PMCID: PMC10503670 DOI: 10.1097/oi9.0000000000000263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 01/04/2023] [Indexed: 09/19/2023]
Abstract
Extra-articular distal radius fractures are often accompanied with shortening, loss of radial height, and radial displacement of the articular segment relative to the shaft of the radius, all seen in the coronal plane. Reduction can be somewhat challenging when reliance on traction and ligamentotaxis fails, especially in subacute or osteoporotic fractures. In this technical report, we describe a technique where application of a laminar spreader between the radius and the ulna in the metaphyseal region can easily reduce the fracture and help attain anatomic alignment in the coronal plane. An acute and a subacute fracture are shown for illustration of the technique.
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Affiliation(s)
- Tarek A. Taha
- Department of Orthopaedic Surgery, Ascension St. Mary's, Saginaw, MI
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Grinčuk A, Petryla G, Masionis P, Sveikata T, Uvarovas V, Makulavičius A. Short-term results and complications of the operative treatment of the distal radius fracture AO2R3 C type, planned by using 3D-printed models. Prospective randomized control study. J Orthop Surg (Hong Kong) 2023; 31:10225536231195127. [PMID: 37620284 DOI: 10.1177/10225536231195127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
Abstract
PURPOSE 3D-printed models rapidly evolving in orthopaedic. Studies show that 3D-printed models used for preoperative planning improve a better understanding of fracture morphology and reduce operative time, blood loss and frequency of fluoroscopy, but there are no studies that investigated possible advantages in the outcomes and complications for the treatment of distal radius fracture (DRF). Our study aims to evaluate short-term functional results and complications between two groups treated DRF using 3D-printed models for preoperative planning and without. We hypothesize that the addition of 3D-printed models would improve functional outcomes and reduce complication rates. METHODS 66 randomized cases of DRF AO/OTA C type were enrolled and divided into "Control group" (n = 33) and "3D-printed model group" (n = 33). Personalized 3D-printed models were created. The primary outcomes were: Patient-Rated Wrist Evaluation questionnaire, Quick Disabilities of the Arm, Shoulder and Hand Score questionnaire, and complications. The secondary outcomes were: measurement of the range of motions, grip strength, radiological evaluation, and the visual analogue scale. Assessments were measured at 6 weeks, 3 months, and 6 months intervals. RESULTS We found that the integration of the 3D-printed model in preoperative planning decreased complication incidence significantly - from 30.3% in the "Control group" to 6.1% in the "3D-printed model group", p = .022. But we did not find a difference in functional and radiological outcomes. CONCLUSION The 3D-printed models for preoperative planning surgically treating DRF AO/OTA C type can help minimize the complication rate, however, they can't improve functional outcomes in the short-term results. LEVEL OF EVIDENCE Level I randomized controlled study.
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Affiliation(s)
- Aleksandr Grinčuk
- Clinic of Rheumatology, Orthopaedics Traumatology, and Reconstructive Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Giedrius Petryla
- Clinic of Rheumatology, Orthopaedics Traumatology, and Reconstructive Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Povilas Masionis
- Clinic of Rheumatology, Orthopaedics Traumatology, and Reconstructive Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Tomas Sveikata
- Clinic of Rheumatology, Orthopaedics Traumatology, and Reconstructive Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Valentinas Uvarovas
- Clinic of Rheumatology, Orthopaedics Traumatology, and Reconstructive Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Aleksas Makulavičius
- Clinic of Rheumatology, Orthopaedics Traumatology, and Reconstructive Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Dang LHN, Nguyen BL, Le HP, Nguyen TT, Le NTN. Experience of Kapandji technique in treating Colles' fracture in central region of Vietnam. SICOT J 2022; 8:41. [PMID: 36169336 PMCID: PMC9517728 DOI: 10.1051/sicotj/2022040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/21/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction: Extra-articular fractures of the distal radius, known as Colles’ fractures, are very common. The optimal management of Colles’ fracture is still controversial. The Kapandji technique is one option for orthopedic surgeons to maintain reduced fractures, however, the effectiveness of this method is no clear consensus. This study aims to access Colles’ fracture treatment by the Kapandji technique with our experiences. Methods: This prospective study of 33 patients treated with three K-wires intra-focal fractures by the Kapandji procedure for Colles’ fractures at Hue University of Medicine and Pharmacy Hospital in Vietnam between February 2017 and May 2019. The functional outcome of the patients was assessed by the demerit score system of Gartland and Werley, and the quality of reduction was elevated on radiographic as well at 3, 6, 12, and 24 weeks postoperative. Results: 33 patients’ mean age is 54.64 ± 18.00; After 24 weeks of postoperative follow-up, 78.79% presented excellent, 21.21% good, and there are not any fair or poor cases on the functional outcome. All patients achieved complete fracture union at 12 weeks postoperative. The average immediate postoperative radial length was 9.85 mm, the radial inclination was 20.64°, and the volar tilt was 9.2°. Conclusion: The study emphasizes that the Kapandji technique in Colles’ fracture treatment is simple and possible to bring a satisfactory outcome and fast recovery.
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Affiliation(s)
- Le Hoang Nam Dang
- Department of Anatomy-Surgical Training, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Ba Luu Nguyen
- Department of Anatomy-Surgical Training, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Hong Phuc Le
- Department of Surgery, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Thanh Thao Nguyen
- Department of Radiology, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Nghi Thanh Nhan Le
- Department of Surgery, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
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Li HF, Yu T, Zhu XF, Wang H, Zhang YQ. Locking compression plate + T-type steel plate for postoperative weight bearing and functional recovery in complex tibial plateau fractures. World J Clin Cases 2022; 10:502-510. [PMID: 35097075 PMCID: PMC8771395 DOI: 10.12998/wjcc.v10.i2.502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/24/2021] [Accepted: 12/03/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Complex tibial plateau fractures can seriously affect quality of life and physical and mental health of patients. The anatomical relationship between the proximal tibial bone and soft tissue is complex, resulting in different types of tibial plateau fractures. Violent trauma can lead to displaced fracture, serious soft tissue injury, and potentially, dislocation of the knee joint. Therefore, tibial plateau fractures are extremely unstable.
AIM To assess the use of locking compression plate (LCP) + T-type steel plate for postoperative weight bearing and functional recovery of complex tibial plateau fractures.
METHODS Ninety-seven patients with complex tibial plateau fractures who underwent surgery at our hospital were selected for retrospective study. Forty-nine patients had been treated with LCP + T-type steel plate limited internal fixation (study group), and 48 patients with bilateral ordinary steel plate support (control group). The operation process index, postoperative rehabilitation related index, Rasmussen score of the knee joint, tibial plateau varus angle (TPA), tibial plateau retroversion angle (PA), and surgical complications of the two groups were compared.
RESULTS The operation time and intraoperative bone graft volume in the study group were lower than those in the control group (P < 0.05). There were no significant differences in surgical bleeding, anterior external incision length, postoperative drainage, hospital stay duration, and fracture healing time between the groups (P > 0.05). There was no significant difference in the TPA and PA angle between the groups immediately and 18 mo after surgery (P > 0.05). At 12 mo after surgery, the Rasmussen scale score was higher in the study group than in the control group (P < 0.05). There was no significant difference in the Rasmussen scale score at 18 mo after surgery, and the radiology score at 12 and 18 mo after surgery, between the two groups (P > 0.05). The postoperative complication rate in the study group (3.77%) was lower than that in the control group (15.09%; P < 0.05).
CONCLUSION LCP + T-type steel plate internal fixation has advantages in terms of minimizing trauma and enabling early postoperative functional exercise, promoting functional recovery and lower limb weight-bearing, and reducing postoperative complications.
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Affiliation(s)
- Hai-Feng Li
- Department of Orthopaedic Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China
| | - Tao Yu
- Department of Orthopaedic Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China
| | - Xing-Fei Zhu
- Department of Orthopaedic Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China
| | - Hua Wang
- Department of Orthopaedic Surgery, Zhabei Central Hospital, Shanghai, Shanghai 200070, China
| | - Ying-Qi Zhang
- Department of Orthopaedic Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China
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Gui XY, Shi HF, Xiong J, Chen YX, Wang JF, Huang J, Qiu XS, Wang YH. A modified intrafocal pinning technique with three-dimensional planning to facilitate volar plating in dorsally comminuted AO/OTA C2 and C3 distal radius fractures. BMC Musculoskelet Disord 2021; 22:379. [PMID: 33892699 PMCID: PMC8066843 DOI: 10.1186/s12891-021-04265-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 04/14/2021] [Indexed: 01/03/2023] Open
Abstract
Backgrounds Theaim of this study was to assess the efficacy of a modified intrafocal pinningtechnique with three-dimensional (3D) planning to facilitate volar plating in dorsally comminuted intra-articular distal radius fractures. Methods Intotal 35 AO/OTA type C2 and C3 fractures were finally included.The 3D digital model of the fracture was reconstructed based on preoperative computedtomographic (CT) images, with the displacement of the comminuted dorsalfragment and the intra-articular fragment analyzed for preoperative planning. During operation, amodified intrafocal pinning technique was applied percutaneously from thedorsal aspect of the radius to reduce the collapsed intra-articular fragmentfollowing volar plating. Adequate reduction was confirmed in all of patientsconsidering radial height, radial inclination and volar tilt in postoperativeradiographs. Results No significant fracture re-displacement wasobserved in most of the cases during a mean follow-up period of 17.4 months, exceptfor two patients withthe C3 fracture. All of the patients achieved adequate clinicalROMs at 12 months postoperatively, with a mean DASH score of 12.0. Most of the patients achievedan excellent (n = 21) or good (n = 12) Gartland and Werley wrist score. Conclusions Ourmodified intrafocal pinning technique with 3D planning contributes to a satisfactoryclinical and radiological outcome in dorsally comminuted intra-articular distalradius fractures fixed with a volar locking plate. Trialregistration Notapplicable because the design of the study is retrospective.
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Affiliation(s)
- Xue-Yang Gui
- Department of Orthopedics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China
| | - Hong-Fei Shi
- Department of Orthopedics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China.
| | - Jin Xiong
- Department of Orthopedics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China.
| | - Yi-Xin Chen
- Department of Orthopedics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China
| | - Jun-Fei Wang
- Department of Orthopedics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China
| | - Jie Huang
- Department of Orthopedics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China
| | - Xu-Sheng Qiu
- Department of Orthopedics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China
| | - Yin-He Wang
- Department of Orthopedics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China
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French JM, Assiotis A, Uppal HS. Use of Surgical Adhesive Tape to Maintain Tension on Intrafocal K-Wires for Easy Reduction and Fixation of Complex Intra-Articular Distal Radius Fractures. Cureus 2021; 13:e12427. [PMID: 33542874 PMCID: PMC7849924 DOI: 10.7759/cureus.12427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Maintaining reduction during fixation of complex intra-articular distal radius fractures with dorsal comminution can be challenging. We describe an operative technique where reduction is achieved with temporary intrafocal Kirschner wires (K-wires), and held using surgical adhesive tape wrapped around the hand, whilst a volar plate is applied to achieve rigid fixation. This is a simple, inexpensive method used at our institutions which allows fixation of these fractures without the need for an operative assistant.
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Affiliation(s)
| | | | - Harpal S Uppal
- Trauma and Orthopaedics, Lister Hospital, Stevenage, GBR
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