PALMAR PLATE FIXATION OF DISTAL RADIUS FRACTURES USING ITS LOCKING PLATE, MID TERM RESULTS AFTER 1–5 YEARS

Abstract

Question: We doveloped a locking plate for palmar fixation of comminuted fractures of the distal radius.

Method: Implant: stability of the angle between screws and plate, achieved by a different hardeness of the locking plate and the screws (pure titanium an titanium alloy), screw holes allow angulation between 70 and 110 degrees, anatomically contoured, low profile plate. The plate can be postioned on the palmar aspect of the radius without expecting a loss of correction. Surgery one week after trauma, palmar approach, open reduction, bone substitute if necessary, dorsal splint for two weeks, physiotherapy.

Follow-up: Retrospective study, period of follow up examinationes: 1–5 years, radiological and clinical examination.

Results: From 2000 until 2004 241 patients with fracturs of the distal radius underwent open reduction an internal fixation with ITS locking plate. Age between 25–81 yeas, 2/3 of the patients were women, 1/3 men. We did the score according to Cooney an the DASH-Score. We could find approximately 80 percent excellent and good results in both scores. Radiological findings: we compared the intraoperative reduction with the healthy other side: an anatomical reduction was achieved in more then 90 percent. At follow up time we mashured length and radial angulation. Shortening was between 0–3 mm, radial tilt maximum 3 degrees.

Conclusion: The anatomical results of reduction could be stabilized until bony union. In mid term follow up examinations most patients reached functional range of motion and normal health related quality of life.