Possibilities of complications prevention in plate osteosyntheses of intra-articular distal radius fractures
Authors:
Martin Vlček 1; Jan Pech 1; Petr Višňa 2; Marek Niedoba 1; David Jonáš
Authors‘ workplace:
Teaching Hospital Motol, 1st Clinic of Orthopaedic Surgery, Prague
1; Fakultní nemocnice v Motole, 1. ortopedická klinika 1. LF UK, Praha
1; Regional Hospital Příbram, Department of Orthopeadics and Traumatology, Příbram
2; Oblastní nemocnice Příbram, a. s, ortopedicko-traumatologické oddělení, Příbram
2
Published in:
Úraz chir. 22., 2014, č.1
Overview
Purpose:
Analyzing of the severity of complication in the treatment of intra-articular distal radius fractures using variable angle locking plates and assessment the possibilities of their prevention.
Material and Methods:
Evaluation of the one-year treatment outcomes in file of 167 patients with distal radius fractures. All fractures were stabilized using variable angle locking plates Aptus Radius applied from volar approach. Indications for operative treatment were unsatisfactory position of bone fragments after closed reduction or secondary dislocation during conservative therapy.
Results:
Secondary dislocation of bone fragments occurred in 12.6 %, with significant loss of correct position occurred in 6.6 % of fractures. Nonunion was observed in 0.6 % of cases. Tendon lesions complicated treatment in 2.4 % fractures. Permanent paresthesia in the median nerve innervation region was reported by 1.2 % of patiens, syndorm of carpal tunnel developed in 1.2 % of cases. At 7.8 % developed complex regional pain syndrome, and 1.2 % of patients left permanent functional limitations.
Conclusion:
Multidirectional locking plates allow good stabilization of intra-articular distal radius fractures with a small number of complications. Tendon lesions by volar plating are rare, prevent them by selecting appropriate length of screws is difficult. Damage of nerve structures can be preceded by careful surgical technique. Secondary dislocation of bone fragments occurs especially in porotic bone, is usually minimal and leads to healing in a satisfactory position. Significant dislocation during fracture healing occurs in extremely comminuted intra-articular fractures in the field of good bone quality.
Key words:
Radius fractures, postoperative complication, prevention.
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