桡骨远端骨折掌、背侧钢板固定的生物力学研究

目的运用生物力学实验应力分析方法评价桡骨远端背侧移位型骨折,掌侧钢板和背侧钢板固定的生物力学性能比较,从而为桡骨远端骨折的治疗提供临床基础理论依据。方法选用10具桡骨远端标本,制作成背侧移位不稳定型桡骨远端骨折,并分为每对2块,随机采用掌侧钢板和背侧钢板固定,将固定好的标本进行生物力学试验。结果 a)桡骨远端背侧移位型骨折,掌侧钢板固定与背侧钢板固定的应力强度、轴向刚度和剪切刚度差异无统计学意义(P0.05);b)采用两种不同钢板固定,其扭转力学性能,扭矩和扭转刚度差异无统计学意义(P0.05);c)将固定好的两种标本进行轴向破坏力学测试,极限强度及骨吸收能量差异无统计学意义(P0.05);d)实验结果与组合杆应力理论分析相比较仅相差6%,佐证了实验应力分析的正确性。结论桡骨远端背侧移位型骨折,掌侧钢板和背侧钢板固定的生物力学性能两者相当,背侧钢板固定略占优势,但差异无统计学意义。从临床手术角度考虑一般采用掌侧钢板固定,简单、方便、实用、疗效较好,是行之有效的术式。     

掌侧锁定钢板联合背侧钛网治疗桡骨远端粉碎性骨折

目的比较掌侧锁定钢板与掌侧锁定钢板联合背侧钛网内固定治疗的桡骨远端粉碎性骨折的疗效。方法57例（65侧）桡骨远端粉碎性骨折患者,根据治疗方法分为锁定钢板固定组（对照组）31例（35侧）和掌侧锁定钢板联合背侧钛网内固定组（钛网组）26例（30侧）,比较两组术后桡骨远端掌倾角、尺偏角、桡骨远端相对长度以及腕关节功能评分。结果57例均得到随访,时间8～24（15．7±6．34）个月。影像学结果显示骨折均愈合。对照组桡骨远端掌倾角9°～17°（12．91°±2．16°）,尺偏角19°～26°（22．60°±1．80°）,桡骨远端相对长度0．9～1．6（1．27±0．18）cm;钛网组桡骨远端掌倾角9°-16°（12．93°±1．89°）,尺偏角19°-26°（22．07°±1．84°）,桡骨远端相对长度0．9～1．6（1．20±0．19）cm;两组比较差异无统计学意义（P〉0．05）,两组分别与参考值比较差异均无统计学意义（P〉0．05）。末次随访时腕关节功能采用Fernandez标准评分：对照组优7侧,良22侧,可4侧,差2侧,优良率82．8％;钛网组优16侧,良11侧,可2侧,差1侧,优良率90．0％,两组比较差异有统计学意义（P〈0．05）。结论掌侧锁定钢板联合背侧钛网内固定治疗桡骨远端粉碎性骨折术后患者腕关节功能恢复效果优于单纯锁定钢板内固定。     

桡骨远端粉碎性骨折掌背侧不同手术入路疗效比较

目的探讨掌背侧不同手术入路对治疗桡骨远端粉碎性骨折的疗效影响。方法对我院自2000年11月～2003年9月收治的85例桡骨远端粉碎性骨折患者(FernandezⅤ型),随机分为A、B两组。分别经腕掌侧(A组)及背侧(B组)入路切开行钢板内固定术。从手术时间、骨折愈合时间、术后早期并发症、术后远期并发症、术后第8周、第24周腕关节功能恢复等方面比较两组差别。结果所有患者术后随访6～36个月,平均13.7个月。参照Gartland和Werley腕关节功能评分,A、B两组术后第24周腕关节功能优良率分别为87.2%和86.8%;放射学评价参照Lidstrom评分,A、B两组桡骨关节面恢复优良率分别为93.2%和91.8%。A、B两组在手术时间、骨折愈合时间、术后早期并发症、术后第24周腕关节功能恢复等方面差异无显著性意义(P>0.05);A、B两组在术后远期并发症、术后第8周腕关节功能恢复方面差异有显著性意义(P<0.01)。结论掌背侧不同手术入路对治疗桡骨远端粉碎性骨折的疗效有影响。掌侧入路钢板内固定术后早期,腕关节旋前功能受影响;背侧入路钢板内固定术后远期并发症较多,骨折愈合后宜尽早拆除内固定钢板。     

掌侧钢板内固定联合桡骨旋前手术治疗桡骨远端粉碎性骨折合并尺背侧骨折

目的探讨掌侧钢板内固定联合桡骨旋前手术治疗桡骨远端粉碎性骨折合并尺背侧骨折的临床疗效。方法回顾性分析自2018-08—2019-06采用掌侧锁定钢板内固定联合术中桡骨旋前手术治疗的31例桡骨远端粉碎性骨折合并尺背侧骨折,比较术前、术后2 d与末次随访掌倾角、尺偏角、桡骨高度。结果 31例均顺利完成手术并获得完整随访,随访时间10～14个月,平均13个月。31例骨折均在术后3个月以内完全愈合,未出现切口感染、骨髄炎和神经损伤、腕关节周围伸肌断裂及激惹等并发症。术后2 d及末次随访时掌倾角、尺偏角、桡骨高度较术前均明显改善,差异有统计学意义(P0.05)。末次随访时X线及CT片显示尺背侧骨折块均未移位,按腕关节功能Gartland-Werley评分评价疗效:优17例,良11例,可3例。结论掌侧钢板内固定联合桡骨旋前手术治疗桡骨远端粉碎性骨折合并尺背侧骨折疗效满意,可以有效防止尺背侧骨块移位。     

桡骨远端骨折掌侧与背侧接骨板固定的生物力学比较

目的 比较背侧移位桡骨远端骨折掌、背侧接骨板内固定后的生物力学性能,为桡骨远端骨折的治疗策略提供实验依据.方法 取6对12块人体桡骨远端标本,制作背侧移位桡骨远端骨折模型,配对标本一侧采用接骨板掌侧内固定,另一侧采用接骨板背侧内固定,固定完成后置于材料测试机上进行轴向压缩实验,实验模式为载荷破坏实验,记录载荷一位移曲线,获得标本破坏时的载荷和骨吸收的能量,实验结果进行统计学配对处理.结果 5对标本在轴向载荷下向掌侧发生成角倾斜,1对标本在轴向载荷下发生骨折端的嵌插.掌侧接骨板固定组的平均破坏载荷为[(1 520.05±579.56)N,x±s,下同],破坏时骨吸收的能量平均为(10.04 ±3.62)J;背侧接骨板固定组的平均破坏载荷为(1 326.77±384.86)N,标本破坏时骨吸收的能量平均为(8.21±3.74)J,组间对比差异无统计学意义(P>0.05).结论 掌侧接骨板固定是治疗桡骨远端骨折理想的固定方式.     

背侧双钢板与掌侧T型钢板治疗桡骨远端不稳定骨折的疗效比较

目的 比较背侧双钢板与掌侧T型钢板治疗桡骨远端不稳定骨折的疗效. 方法 回顾性分析2008年8月至2010年8月收治的28例桡骨远端不稳定骨折患者资料,男8例,女20例;年龄31～65岁,平均50.7岁;所有骨折均为闭合性骨折.骨折按照AO分型:A3型4例,B3型2例,C1型5例,C2型6例,C3型11例.根据治疗方式不同,分为双钢板组(采用背侧双钢板固定)11例和T型钢板组17例(采用掌侧T型钢板固定).比较两组患者手术时间、骨折愈合时间、掌倾角、尺偏角、术后早期和远期并发症、术后腕关节功能恢复等. 结果 所有患者术后获12 ～ 16个月(平均14.4个月)随访.两组患者在骨折愈合时间掌倾角、尺偏角、术后早期并发症、腕关节功能恢复等方面差异均无统计学意义(P＞0.05);但两组患者在手术时间、术后远期并发症差异有统计学意义(P＜0.05). 结论 采用背侧双钢板或掌侧T型钢板治疗桡骨远端不稳定骨折,各有其适应证和优、缺点,背侧双钢板技术手术时间相对延长,但远期并发症较掌侧钢板相对减少.     

两种不同内固定方法治疗背侧移位桡骨远端“C”型骨折疗效分析

[目的]探讨掌侧"T"型锁定加压钢板和桡背侧双锁定加压钢板内固定方法治疗背侧移位桡骨远端"C"型骨折的临床疗效。[方法]回顾性分析本院2010年6月²012年6月收治的桡骨远端"C"型骨折40例,采用掌侧"T"型锁定加压钢板内固定方法治疗20例,采用桡背侧双锁定加压钢板治疗20例,比较两种内固定方法的临床疗效。[结果]40例患者均获随访,随访时间62012年6月收治的桡骨远端"C"型骨折40例,采用掌侧"T"型锁定加压钢板内固定方法治疗20例,采用桡背侧双锁定加压钢板治疗20例,比较两种内固定方法的临床疗效。[结果]40例患者均获随访,随访时间6¹8个月,平均12个月。腕关节功能按conney评分方法评价,放射学评价按改良Lidstrom-Radiographic标准评价。腕关节功能评价掌侧"T"型锁定加压钢板组优良率60%,桡背侧双锁定加压钢板组优良率90%,差异有统计学意义(P<0.05)。放射学评价掌侧"T"型锁定加压钢板组掌倾角(9.50±2.37)°,尺偏角(17.80±2.48)°,桡骨高度(9.50±2.83)mm,关节面台阶(2.00±1.30)mm;桡背侧双锁定加压钢板组掌倾角(11.05±2.06)°,尺偏角(20.10±2.34)°,桡骨高度(11.25±2.02)mm,关节面台阶(1.10±0.72)mm。两组掌倾角、尺偏角、关节面台阶、桡骨高度差异均有统计学意义(P<0.05)。两组术后并发症比较,术后早期并发症差异无统计学意义(P>0.05),术后远期并发症差异无统计学意义(P>0.05)。[结论]对于背侧移位桡骨远端"C"型骨折,桡背侧双锁定加压钢板内固定方法腕关节功能恢复优于掌侧"T"型锁定加压钢板内固定方法,桡背侧双锁定加压内固定术术后桡骨远端关节面恢复优于掌侧"T"型锁定加压钢板内固定。两种内固定方法早、远期并发症无明显差别。     

比较掌侧和背侧入路锁定钢板内固定治疗不稳定性桡骨远端骨折的效果

目的比较掌侧和背侧入路锁定钢板内固定治疗不稳定性桡骨远端骨折的效果。方法根据不同手术入路将接受锁定钢板内固定治疗的94例不稳定性桡骨远端骨折患者分为2组,各47例。对照组采用背侧入路,观察组采用掌侧入路。回顾性分析患者的临床资料。结果术后2组患者的尺偏角、掌倾角均优于术前,差异有统计学意义(P0.05);但2组差异无统计学意义(P0.05)。观察组术后并发症发生率较对照组低,差异有统计学意义(P0.05)。术后随访1 a,依据Mcbridgi评分标准,观察组腕关节优良率为87.23%,对照组为85.11%,2组差异无统计学意义(P0.05)。结论掌侧入路与背侧入路锁定钢板内固定治疗不稳定性桡骨远端骨折,均有良好复位效果,但掌侧入路的并发症少,安全性较高。     

背侧入路双钢板内固定治疗桡骨远端C型背侧粉碎性骨折

目的探讨应用尺桡骨远端三柱理论经背侧入路双钢板内固定治疗桡骨远端C型背侧粉碎性骨折的效果。方法应用尺桡骨远端三柱理论经背侧入路双钢板内固定治疗21例桡骨远端C型背侧粉碎性骨折。结果 21例术后随访5～19个月,骨折平均愈合时间为8周。根据Gartland与Werley评分标准:优7例,良10例,一般4例,优良率81.0%。结论对于桡骨远端C型背侧粉碎性骨折,应用尺桡骨远端三柱理论经背侧入路双钢板内固定可较好地达到骨折复位固定,允许早期功能锻炼,临床疗效满意。     

掌侧和背侧钢板内固定治疗背侧不稳定性桡骨远端骨折的病例对照研究

目的:探讨两种不同手术入路内固定方法对背侧不稳定性桡骨远端骨折的疗效。方法:收集2006年8月至2010年10月采用手术切开复位钢板内固定治疗,并获得随访的病例47例。男21例,女26例;年龄39～73岁。所有患者分为2组:采用掌侧入路掌侧钢板内固定(A组)32例,锁定钢板27例,普通"T"形钢板5例,其中4例联合应用背侧克氏针内固定;采用背侧钢板内固定(B组)15例,其中锁定钢板7例,普通"T"形钢板8例。术后从腕关节功能、X线评分及并发症等方面对掌侧和背侧钢板2种固定方法的疗效进行比较。结果:掌侧和背侧钢板固定术后1周与术前比较,掌倾角、尺偏角及桡骨茎突高度均明显改善;2组术后1周与术后半年比较,掌倾角、尺偏角及桡骨茎突高度均无明显丢失。术后A组正中神经牵拉伤1例,切口感染1例,肌腱粘连2例;B组切口红肿感染1例,肌腱粘连1例,拇长伸肌腱刺激3例;掌侧钢板内固定并发症的发生率低于背侧钢板内固定。腕关节功能评价:A组优17例,良11例,可3例,差1例;B组优8例,良4例,可2例,差1例;掌侧钢板内固定与背侧钢板内固定疗效无明显差异。结论:背侧移位的桡骨远端不稳定骨折,采用掌侧入路掌侧钢板内固定同样可以达到良好的复位效果,而肌腱损害等并发症较背侧钢板固定更少。     

Biomechanics in uniaxial compression of three distal radius volar plates

PURPOSE: A new fixed-angle volar plate for a dorsally displaced distal radius fracture was designed with the aim of avoiding soft tissue problems due to dorsal plating. The purpose of this study was to compare the biomechanical properties of this new plate with 2 existing volar plates in a cadaver model. METHODS: Three different plates were applied on surgically simulated unstable extra-articular distal radius fractures in formalin-fixed cadaver radiuses. Group 1 (volarly placed AO titanium Distal Radius plates [Synthes Ltd, Paoli, PA]; n = 6), group 2 (volarly placed titanium Symmetry plates [DePuy ACE Co, El Segundo, CA]; n = 6), and group 3 (volarly placed newly designed titanium plates; n = 6) were tested to failure under axial compression with a materials testing machine. Specimens of all 3 groups had similar bone mineral density. RESULTS: Group 3 specimens had significantly greater elastic limit and ultimate strength than the other 2 groups. Specimens of group 3 had the greatest rigidity, although this was statistically insignificant compared with the other 2 groups. All plates (groups 1, 2, 3) failed in apex volar angulation. CONCLUSIONS: The newly designed plate fixation system is the strongest of the systems tested and may offer adequate stability for the treatment of a distal radius fracture in which the dorsal and/or volar metaphyseal cortex is comminuted severely.     

Volar fixed-angle plating of the distal radius

The treatment of unstable distal radius fractures continues to improve as better methods of skeletal fixation and soft-tissue management are developed. Apart from closed reduction and percutaneous pinning of simpler fracture patterns, the three main methods of management are external fixation, dorsal plating, and volar fixed-angle plating. Specific advantages of volar fixed-angle plating include stable fixed-angle support that permits early active wrist rehabilitation, direct fracture reduction, and fewer soft-tissue and tendon problems. Volar fixed-angle plating also avoids the complications often associated with external fixation and dorsal plating. Biomechanical data indicate that, when loaded to failure, volar fixed-angle plates have significant strength advantages over dorsal plating. Volar fixed-angle plating is advantageous in elderly osteopenic patients and for high-energy comminuted fractures and malunions requiring osteotomy.     

Volar versus dorsal plating in the management of intra-articular distal radius fractures

PURPOSE: To compare the complications and functional and radiographic outcomes of volar and dorsal plating of intra-articular distal radius fractures. METHODS: This retrospective review included 34 patients found by searching a database of 350 patients treated for distal radius fractures. Inclusion criteria were (1) at least 1 year of follow-up data and (2) open reduction and internal fixation of a multifragmentary fragment intra-articular distal radius fracture with either a nonlocking volar or dorsal plate. Twenty patients were treated with a dorsal plate and 14 patients were treated with a volar nonlocking plate. Objective and subjective outcome parameters were compared between the 2 groups. Objective evaluations included wrist range of motion, grip strength, and preoperative and postoperative radiographic parameters (radial inclination, palmar tilt, ulnar variance, fracture pattern). Subjective evaluations were performed using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire score and the Gartland and Werley score. RESULTS: Volar plating resulted in a significantly better Gartland-Werley score compared with dorsal plating. There were no significant differences in the DASH score.Volar collapse was documented in 5 of the 20 patients in the dorsal plating group, which resulted in a mild loss of pronation compared with the volar plating group. No collapse occurred in the volar plating group. In addition the difference in the percentage of wrist range of motion compared with the contralateral wrist was not significant. Dorsal plating was associated with a ruptured extensor indicis tendon in 1 patient; secondary surgical procedures were required in 4 patients (tenolyses and radial styloidectomy). Volar plating was associated with median nerve neuropathy in 2 patients and intersection syndrome in one. CONCLUSIONS: Although both groups of patients had similar DASH scores the functional outcome in terms of Gartland and Werley scores was better in the volar plating group. In addition there was a higher rate of volar collapse and late complications in the dorsal plating group compared with the volar plating group. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic, Level III.     

不同固定方法治疗不稳定性桡骨远端关节内骨折的离体生物力学评估

目的比较5种不同固定方法对不稳定性桡骨远端关节内骨折的作用。方法采用标准的截骨法制备不稳定性桡骨远端关节内骨折的尸体模型,然后测量外固定伴或不伴克氏针固定、背侧钢板内固定、掌侧钢板内固定及双侧支撑钢板固定5种方法对恢复桡骨稳定性及轴向力传导的作用,并与正常对照组进行比较。结果外固定伴克氏针固定和掌侧钢板内固定是其中最稳定的方法,其次是背侧钢板内固定及单纯外固定,双侧支撑钢板固定则最不稳定。结论本研究的结果对临床治疗方案的选择提供有意义的参考。     

Comparison of different distal radius dorsal and volar fracture fixation plates: a biomechanical study

PURPOSE: To compare the biomechanical properties of 6 dorsal and volar fracture fixation plate designs in a cadaver model. METHOD: Six different plating techniques were used on surgically simulated, unstable, extra-articular distal radius fractures in fresh-frozen cadavers. Specimens were tested to failure in axial compression with the Materials Testing System machine, and were analyzed with a motion analysis system. The 6 different fixation systems studied included an AO stainless steel Pi plate (group 1), an AO titanium Pi plate (group 2), a Forte plate (group 3), a dorsally placed Symmetry plate (group 4), a volarly placed Symmetry plate (group 5), and a volarly placed SCS/V plate (group 6). RESULTS: All dorsal plates (groups 1, 2, 3, 4) failed in apex dorsal angulation and all volar plates (groups 5, 6) failed in apex volar angulation. No group developed an average angular deformity greater than 5 degrees with a load of 100 N, which compares with the physiologic loads expected with active wrist motion. Only the volarly placed SCS/V plated specimens (group 6) resisted deformation of 5 degrees or more at loads up to 250 N, which compares with the physiologic loads expected with active finger motion, and was significantly stronger and more rigid than the other 5 plate groups. CONCLUSIONS: The SCS/V plate fixation system is the most rigid of the systems tested and may offer adequate stability for the treatment of the distal radius fracture in which the anterior and/or posterior metaphyseal cortex is comminuted severely.     

Volar versus dorsal locking plates with and without radial styloid locking plates for the fixation of dorsally comminuted distal radius fractures: A biomechanical study in cadavers

PURPOSE: To compare the stability and stiffness of dorsal and volar fixed-angle distal radius constructs in a cadaveric model. METHODS: A locking distal radius system was used in a combination of a dorsal and styloid plate (group 1), a single volar plate (group 2), and a combination of a volar and styloid plate (group 3) configuration. In addition a single volar 3.5-mm steel locking plate was used in group 4. Each construct was tested on 6 fresh-frozen radii with simulated unstable dorsally comminuted extra-articular distal radius fractures. Specimens were tested on a material testing machine with an extensometer and subjected to axial compression fatigue and load-to-failure testing. RESULTS: No construct failed in fatigue testing of 250 N for 5,000 cycles. Two specimens in each group were tested for 20,000 cycles without failure. The plastic deformation in the double-plate groups was lower compared with the single-plate groups, although the difference was not statistically significant. Group 1 had the highest and group 4 the lowest failure load and stiffness, respectively. The differences between group 1 and the other groups, except failure load compared with group 3, were statistically significant. Groups 2 and 3 had a significantly higher load to failure and group 3 had a significantly higher stiffness compared with group 4. CONCLUSIONS: All constructs offer adequate stability with minimal deformation on fatigue testing under physiologic conditions. Dorsal fixed-angle constructs are stiffer and stronger than volar constructs. The addition of a styloid plate to a volar plate did not significantly improve stability in this model of simulated extra-articular dorsal comminution loaded in axial compression.     

Biomechanical comparison of fixed-angle volar plate versus fixed-angle volar plate plus fragment-specific fixation in a cadaveric distal radius fracture model

PURPOSE: To test the hypothesis that combining orthogonal fragment-specific fixation with volar fixed-angle fixation provides markedly higher interfragment stability and construct strength compared with volar fixed-angle fixation alone. METHODS: Eight matched pairs of fresh cadaveric hand and forearm specimens were potted upright in cement. Flexor and extensor tendons were isolated at insertion sites and sutured into a looped bundle for loading in flexion and extension, respectively (up to 61 N). Osteotomies to simulate an AO type C2, 3-part fracture pattern were created with a saw. One randomized specimen from each pair received a locking volar plate and a radial pin plate (VP+PP), and the other received a locking volar plate only (VP). The relative angular displacements between the radial, ulnar, and proximal fragments were obtained with a motion analysis system. After stability tests, specimens were compressed to failure in a wrist-extended position on a material testing machine. Paired t tests were used to compare the interfragment displacement, construct stiffness, and strength between the 2 groups. RESULTS: Comparing fragment displacement in the VP+PP and VP groups showed that with flexion-extension and radial-ulnar deviation, distal fragment displacement was reduced to a statistically significant degree. The VP+PP group also showed higher failure strength and construct rigidity than the VP group. CONCLUSIONS: In a simulated cadaveric model of the distal radius intra-articular fracture, the combined technique of fragment-specific plating with volar fixed-angle fixation alone provides superior biomechanical strength and stability over the volar fixed-angle fixation alone.     

Volar versus dorsal fixed-angle fixation of dorsally unstable extra-articular distal radius fractures: a biomechanic study

PURPOSE: To evaluate and compare the biomechanic rigidity and strength of 3 fixed-angle plates used to treat extra-articular distal radius fractures that are dorsally unstable. Volar fixed-angle plates were compared with a dorsal fixed-angle nail plate. METHODS: Three plate constructs were tested: the dorsal nail plate (DNP), distal volar radius (DVR) plate, and locking compression plate (LCP) volar distal radius plate. With anatomic, third-generation, artificial composite radii, dorsally unstable extra-articular distal radius fracture models were made by cutting a wedge osteotomy with an 8-mm dorsal gap 1 cm from the articular surface. These models were then fixed with the 3 implants by the method recommended by the manufacturer. The proximal radii of each specimen were attached to the base of a materials testing machine with a probe centered at the radial side of the lunate fossa. The specimens were loaded at a constant rate to failure under axial compression. Load and displacement were plotted graphically, and the resulting rigidities and strengths of each plate were assessed statistically. RESULTS: The DVR group had significantly greater stiffness than the LCP group. The DVR group had significantly higher maximum loads than both the DNP and LCP groups. There were no significant differences in yield loads. Both the DNP and DVR groups had significantly less displacement at yield than the LCP group. CONCLUSIONS: These 3 groups had similar yield loads. However, the LCP was less stiff than the DVR and had more displacement at yield than both the DVR and DNP. The yield load of all 3 implants was much higher than previously described loads for active wrist and finger motion.     

Distal radius fractures and the volar lunate facet fragment: Kirschner wire fixation in addition to volar-locked plating

Background

The volar lunate facet fragment of a distal radius fracture may not be stabilized with volar-locked plating alone due to the small size and distal location of the fragment. Identification and stabilization of this small fragment is critical as unstable fixation may result in radiocarpal and radioulnar joint subluxation. The addition of spring wire fixation with volar plating can provide stable internal fixation of this critical fracture fragment.

Methods

A retrospective review (2006–2011) identified nine patients with distal radius fractures with an associated volar lunate facet fragment that were treated with volar-locked plating and spring wire fixation of the volar lunate facet fragment. Radiographic indices, range of motion, grip strength, and postoperative Patient-related wrist evaluation (PRWE) scores were obtained to assess pain and function.

Results

All distal radius fractures healed, and the volar lunate facet fragment reduction was maintained. The mean follow-up was 54 weeks. Mean active range of motion was 46° wrist flexion, 51° wrist extension, 80° pronation, and 68° supination. The mean grip strength was 21 Kg, achieving 66 % of the uninjured limb. The average PRWE score was 17. No patient required removal of hardware or had evidence of tendon irritation.

Conclusions

The addition of spring wire fixation to volar-locked plating provided stable fixation of the volar lunate facet fragment of distal radius fractures without complication. This technique addresses a limitation of volar-locked plating to control the small volar lunate facet fragment in distal radius fractures otherwise amenable to volar plating.

Level of Evidence

A retrospective case series, Level IV.