
pmid: 19809226
Abstract Objectives: We evaluated radiographic and functional results of volar locking plate fixation of unstable distal radius fractures. \r\nMethods: The study included 27 patients (15 males, 12 females; mean age 45 years; range 18 to 77 years) who were treated with volar locking plate fixation for unstable distal radius fractures. Twenty-two patients (81.5%) had AO type C and five (18.5%) had type B fractures. Two patients (7.4%) had type I open fractures. Dorsal and volar angulation were present in 21 (77.8%) and six (22.2%) fractures, respectively. Four patients (14.8%) also had elbow dislocation and/or fracture and nine patients (33.3%) had disruption of the distal radioulnar joint. Autologous iliac crest graft was used in 10 patients (37%). Postoperative assessments included range of movement and grip strength measurements, and radiographic parameters using the Stewart criteria. Functional results were assessed using the Q-DASH (Quick-Disabilities of the Arm, Shoulder and Hand) questionnaire and the Gartland-Werley scale. The mean follow-up was 18 months (range 12 to 34 months).\r\nResults: All fractures united without a problem within a mean of 6.5 weeks (range 6 to 8 weeks). The following parameters became equal to the unaffected side: ulnar variance (n=21, 77.8%), radial inclination angle (n=13, 48.2%), radial tilt angle (n=8, 29.6%), and radial height (n=11, 40.7%). The mean radiographic Stewart score was 0.5 (range 0 to 3). The mean grip strength of the operated side was 72.4% (18 kg) of the normal side. The mean Q-DASH and Gartland-Werley scores were 8.3 (range 0 to 70.5) and 4.7 (range 0 to 16), respectively. According to the Gartland-Werley scale, the results were excellent in 12 patients (44.4%), good in 12 patients, and moderate in three patients (11.1%). Three complications (11.1%) occurred, including loss of alignment in two patients, and screw-related discomfort in one patient.\r\nConclusion: Volar locking plate fixation is an effective treatment in the anatomical and functional restoration of unstable distal radius fractures. Özet Amaç: Volar yerleşimli kilitli plak vida tespitleri ile tedavi edilen instabil radius alt uç kırıklarının radyografik ve işlevsel sonuçları değerlendirildi.\r\nÇalışma planı: Radius alt uç instabil kırığı nedeniyle volar yerleşimli kilitli plak tespiti uygulanan 27 hasta (15 erkek, 12 kadın, ort. yaş 45; dağılım 18-77) incelendi. AO sınıflamasına göre kırıkların 22’si (%81.5) tip C, beşi (%18.5) tip B idi. İki hastada (%7.4) tip I açık kırık vardı. Kırıkların 21’inde (%77.8) dorsal, altısında (%22.2) volar açılanma vardı. Dört hastada (%14.8) kırığa dirsek çıkığı ve/veya kırık eşlik etmekteydi. Dokuz hastada (%33.3) distal radioulnar eklem sorunları vardı. On hastada (%37) kırık tespitine ek olarak otolog krista iliyka grefti kullanıldı. Hastaların hareket açıklıkları, kavrama kuvvetleri ölçüldü, Stewart ölçütlerine göre radyografik değerlendirmeleri yapıldı. Fonksiyonel değerlendirmede Quick-DASH-T (Disabilities of the Arm, Shoulder and Hand-Türkçe) sorgulaması ve Gartland-Werley değerlendirme formu kullanıldı. Ortalama takip süresi 18 ay (dağılım 12-34 ay) idi.\r\nSonuçlar: Kırıkların tümü ortalama 6.5 haftada (dağılım 6-8 hafta) sorunsuz kaynadı. Yirmi bir hastada (%77.8) ulnar varyans, 13 hastada (%48.2) radial inklinasyon açısı, sekiz hastada (%29.6) radial tilt açısı, 11 hastada (%40.7) radial yükseklik sağlam tarafla eşitlendi. Stewart ölçütlerine göre ortalama radyografi puanı 0.5 (dağılım 0-3) bulundu. Tedavi edilen tarafta kavrama gücü, sağlam tarafın ortalama %72.4’ü (18 kg) idi. Quick-DASH-T skoru ortalaması 8.3 (dağılım 0-70.5), Gartland-Werley puanı ortalaması 4.7 (dağılım 0-16) bulundu. Gartland-Werley değerlendirmesine göre, 12 hastada (%44.4) mükemmel, 12 hastada iyi, üç hastada (%11.1) ise orta sonuç alındı. İki hastada dizilim kaybı ve bir hastada çevre dokularda uyumsuzluk olmak üzere üç (%11.1) hastada komplikasyon görüldü.\r\nÇıkarımlar: Volar yerleşimli kilitli plak uygulamaları radius alt uç anatomisinin düzeltilmesinde ve korunmasında etkilidir.
Adult, Male, Adolescent, Hand Strength, Equipment Design, Middle Aged, Iliac Artery, Transplantation, Autologous, Radiography, Fractures, Open, Young Adult, Surgical Fixation Devices, Humans, Female, Range of Motion, Articular, Radius Fractures, Aged
Adult, Male, Adolescent, Hand Strength, Equipment Design, Middle Aged, Iliac Artery, Transplantation, Autologous, Radiography, Fractures, Open, Young Adult, Surgical Fixation Devices, Humans, Female, Range of Motion, Articular, Radius Fractures, Aged
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