Luigi Tarallo1, Raffaele Mugnai, Francesco Zambianchi, Roberto Adani, Fabio Catani. 1. *Orthopaedics and Traumatology Department, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy; and †Hand and Microsurgery Department, Policlinico GB Rossi, Azienda Ospedaliera Universitaria Verona, Verona, Italy.
Abstract
OBJECTIVES: Determining the rate of specific adverse events after volar plating performed for distal radius fractures. DESIGN: Retrospective. SETTING: University level I trauma center. PATIENTS: We searched the electronic database of all surgical procedures performed in our department using the following keywords: distal radius fracture, wrist fracture, and plate fixation. We identified 315 patients, 12 of whom were lost at follow-up. INTERVENTION: Volar plate fixation for the treatment of distal radius fractures. MAIN OUTCOME MEASUREMENTS: At an average follow-up of 5 years, 303 patients were evaluated through medical records and clinical and radiographic assessment for specific adverse events after volar plate fixation. RESULTS: Adverse events were observed in 18 patients (5.9%). Implant-related adverse events, including tendon impairments, intra-articular screws, and screw loosening, were observed in 15 patients (5.0%). Extensor tendon impairments were represented by 5 cases of extensor tenosynovitis and 3 cases of rupture of the extensor pollicis longus due to screws protruding dorsally. Flexor impairments were represented by 2 cases of tenosynovitis and 2 cases of flexor pollicis longus rupture. Screw penetration into the radioulnar joint was observed in 1 case. Loss of reduction was identified in 3 cases. One patient had a deep postoperative infection treated with operative debridement. One patient experienced injury to the median nerve during routine implant removal unrelated to tendon issues. CONCLUSIONS: The majority of adverse events after volar plate fixation were due to technical errors in implant placement. In our cohort, tendon impairments were the most frequently observed; among these, extensor tendon impairments were the most represented (50% of all adverse events). All 12 tendon-related adverse events were due to technical shortcomings with implant placement. LEVEL OF EVIDENCE: Therapeutic level IV.
OBJECTIVES: Determining the rate of specific adverse events after volar plating performed for distal radius fractures. DESIGN: Retrospective. SETTING: University level I trauma center. PATIENTS: We searched the electronic database of all surgical procedures performed in our department using the following keywords: distal radius fracture, wrist fracture, and plate fixation. We identified 315 patients, 12 of whom were lost at follow-up. INTERVENTION: Volar plate fixation for the treatment of distal radius fractures. MAIN OUTCOME MEASUREMENTS: At an average follow-up of 5 years, 303 patients were evaluated through medical records and clinical and radiographic assessment for specific adverse events after volar plate fixation. RESULTS: Adverse events were observed in 18 patients (5.9%). Implant-related adverse events, including tendon impairments, intra-articular screws, and screw loosening, were observed in 15 patients (5.0%). Extensor tendon impairments were represented by 5 cases of extensor tenosynovitis and 3 cases of rupture of the extensor pollicis longus due to screws protruding dorsally. Flexor impairments were represented by 2 cases of tenosynovitis and 2 cases of flexor pollicis longus rupture. Screw penetration into the radioulnar joint was observed in 1 case. Loss of reduction was identified in 3 cases. One patient had a deep postoperative infection treated with operative debridement. One patient experienced injury to the median nerve during routine implant removal unrelated to tendon issues. CONCLUSIONS: The majority of adverse events after volar plate fixation were due to technical errors in implant placement. In our cohort, tendon impairments were the most frequently observed; among these, extensor tendon impairments were the most represented (50% of all adverse events). All 12 tendon-related adverse events were due to technical shortcomings with implant placement. LEVEL OF EVIDENCE: Therapeutic level IV.
Authors: Florian Oehme; Björn Christian Link; Herman Frima; Tim Schepers; Steven J Rhemrev; Reto Babst; Frank J P Beeres Journal: Eur J Trauma Emerg Surg Date: 2018-07-07 Impact factor: 3.693
Authors: T Kyle Stoops; Brandon G Santoni; Nicolette M Clark; Amy A Bauer; Christopher Shoji; Francisco Schwartz-Fernandes Journal: Hand (N Y) Date: 2016-11-01
Authors: Agnes Z Dardas; Charles A Goldfarb; Martin I Boyer; Daniel A Osei; Christopher J Dy; Ryan P Calfee Journal: J Hand Surg Am Date: 2018-02-01 Impact factor: 2.230
Authors: Sascha Rausch; Ivan Marintschev; Isabel Graul; Arne Wilharm; Kajetan Klos; Gunther O Hofmann; Marc Florian Gras Journal: Arch Trauma Res Date: 2015-06-20