Internal fixation of distal radius fractures with dorsal dislocation: pi-plate or two 1/4 tube plates? A prospective randomized study.

Détails

ID Serval
serval:BIB_32E3A98DDCCF
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Internal fixation of distal radius fractures with dorsal dislocation: pi-plate or two 1/4 tube plates? A prospective randomized study.
Périodique
Journal of Trauma
Auteur(s)
Hahnloser D., Platz A., Amgwerd M., Trentz O.
ISSN
0022-5282 (Print)
ISSN-L
0022-5282
Statut éditorial
Publié
Date de publication
1999
Volume
47
Numéro
4
Pages
760-765
Langue
anglais
Notes
Publication types: Clinical Trial ; Comparative Study ; Journal Article ; Randomized Controlled TrialPublication Status: ppublish
Résumé
BACKGROUND: Severely comminuted distal radius fractures can be treated by different methods. Our routine procedure in dorsal dislocated fractures is the dorsal stabilization with two 1/4 tube plates. The new pi-plate is an other device that matches optimally the anatomy of the distal radius and allows a near half-circumferential dorsal buttress of comminuted intraarticular and extra-articular radial fractures.
METHODS: In a prospective randomized study, comminuted distal radius fractures with dorsal displacement were stabilized either with two 1/4 tube plates or with the pi-plate. All patients were reviewed at 1, 3, and 6 months after surgery by thorough clinical examination and standard radiographs of both wrists. Results were analyzed and compared in both groups.
RESULTS: Subjective and objective results in the pi-plate group are disappointing. Although optimal anatomic results were achieved, the complication-rate was high (14.3%) and the range of motion was limited. At final review, extension and flexion of the injured wrist had recovered to an average of 67% of the normal, contralateral side. Radial and ulnar deviation were limited to 64%, whereas pronation and supination reached 89% and 87%, respectively. Overall, results were good to excellent only in 56%. In a comparable group of patients with similar fractures and stabilization with two 1/4 tube plates, 82% of patients achieved excellent to good results, wrist motion was significantly better (p < 0.05), and no complications occurred.
CONCLUSION: With open reduction, cancellous bone grafting, and internal plate fixation in comminuted distal radial fractures, excellent results can be achieved. In our experience, we cannot recommend the 7pi-plate in its current shape and prefer to stabilize distal radius fractures and dorsal fragment dislocations with two 1/4 tube plates.
Mots-clé
Adolescent, Adult, Aged, Bone Plates, Colles' Fracture/classification, Colles' Fracture/physiopathology, Equipment Design, Female, Fracture Fixation, Internal/adverse effects, Fracture Fixation, Internal/instrumentation, Fracture Healing, Fractures, Comminuted/classification, Fractures, Comminuted/physiopathology, Humans, Length of Stay/statistics & numerical data, Male, Middle Aged, Pronation, Prospective Studies, Range of Motion, Articular, Supination, Treatment Outcome
Pubmed
Création de la notice
07/10/2014 14:44
Dernière modification de la notice
20/08/2019 14:18
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