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Clinical results of using minimally invasive long plate osteosynthesis versus conventional approach for extensive comminuted metadiaphyseal fractures of the radius.

Abstract：

INTRODUCTION:The minimally invasive plate osteosynthesis (MIPO) technique has been introduced recently. The extensive comminuted fractures of the distal radial metaphysis with diaphyseal involvement are probably good indications for MIPO technique because of less extensive dissection and soft-tissue stripping. The purpose of this retrospective study was to compare the clinical results of MIPO technique to those of conventional open reduction in extensive metadiaphyseal fractures of distal radius. MATERIALS AND METHODS:Of 34 patients treated for comminuted metadiaphyseal fractures of the distal radius between June 2006 and May 2012, all the patients had extra-articular fractures. Twenty-one patients underwent MIPO technique and 13 underwent conventional open reduction with long periarticular locking plates system (Zimmer). Six patients in the MIPO group and three in the conventional group who had concomitant distal ulnar fractures or distal radioulnar joint (DRUJ) injury underwent plate osteosynthesis or Kirschner-wire fixation before radial fixation. Perioperative parameters and union time were recorded. Radiologic assessment, Mayo Wrist Score, and satisfaction scale were evaluated at the final follow-up. RESULTS:All fractures united without secondary procedures. Radiologic assessment, Mayo wrist score, and time to union showed no significant difference between the two groups, but the MIPO group had significantly smaller incision wound, higher satisfaction scale, and shorter operative time than did the conventional group. CONCLUSIONS:MIPO is capable of achieving functional results as good as those of conventional open reduction, with a higher satisfaction scale, smaller incision, and shorter operative time. When MIPO intervention is planned, concurrent distal ulnar fracture or DRUJ injury should be repaired first, thus facilitating subsequent indirect reduction. For treating intra-articular fractures, anatomical reduction of the articular surface is more important, and the MIPO technique described here is not recommended.

journal_name

Arch Orthop Trauma Surg

journal_title

Archives of orthopaedic and trauma surgery

authors

Chen CY,Lin KC,Yang SW,Renn JH,Tarng YW

doi

10.1007/s00402-015-2162-5

subject

Has Abstract

pub_date

2015-03-01 00:00:00

pages

361-7

issue

eissn

0936-8051

issn

1434-3916

journal_volume

135

pub_type

杂志文章

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Clinical results of using minimally invasive long plate osteosynthesis versus conventional approach for extensive comminuted metadiaphyseal fractures of the radius.