APPLICATION OF BUTTERFLY SHAPED LOCKING COMPRESSIO PLATE IN COOMPLEX DISTAL RADIUS FRACTURES_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

JIANGZongyuan ,  MATao , XIAJiang , HUCaizhi , XULei

Department of Hand Surgery, Yijishan Hospital of Wannan Medical College, Wuhu Anhui, 241000, P. R. China;

Corresponding?author：

MATao, Email: matao1984721@163.com

Keywords：

Butterfly shaped locking compression plate; Complex distal radius fracture; Internal fixation; Radial styloid process fracture; Sigmoid notch fracture

DOI：

10.7507/1002-1892.20140147

Video：

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Objective To investigate the effectiveness of butterfly shaped locking compression plate for the treatment of complex distal radius fractures. Methods Between June 2011 and January 2013, 20 cases of complex distal radius fractures were treated with butterfly shaped locking compression plate fixation. There were 11 males and 9 females with an average age of 54 years (range, 25-75 years). Injury was caused by falling in 10 cases, by traffic accident in 7 cases, and by falling from height in 3 cases. All of fractures were closed. According to AO classification system, there were 8 cases of type C1, 8 cases of type C2, and 4 cases of type C3. Of them, 9 cases had radial styloid process fracture, 4 cases had sigmoid notch fracture, and 7 cases had both radial styloid process fracture and sigmoid notch fracture. The mean interval between injury and operation was 5.2 days (range, 3-15 days). Results All incisions healed by first intention; no complications of infection and necrosis occurred. All cases were followed up 14 months on average (range, 10-22 months). All factures healed after 9.3 weeks on average (range, 6-11 weeks). No complications such as displacement of fracture, joint surface subsidence, shortening of the radius, and carpal tunnel syndrome were found during follow-up. At last follow-up, the mean palmar tilt angle was 10.2°(range, 7-15°), and the mean ulnar deviation angle was 21.8°(range, 17-24°). The mean range of motion of the wrist was 45.3°(range, 35-68°) in dorsal extension, 53.5°(range, 40-78°) in palmar flexion, 19.8°(range, 12-27°) in radial inclination, 26.6°(range, 18-31°) in ulnar inclination, 70.2°(range, 45-90°) in pronation, and 68.4°(range, 25-88°) in supination. According to the Dienst scoring system, the results were excellent in 8 cases, good in 10 cases, and fair in 2 cases, and the excellent and good rate was 90%. Conclusion Treatment of complex distal radius fractures with butterfly shaped locking compression plate can reconstruct normal anatomic structures, especially for radial styloid process and sigmoid notch fractures, and it can get good functional recovery of the wrist and the distal radioulnar joint.

Citation： JIANGZongyuan, MATao, XIAJiang, HUCaizhi, XULei. APPLICATION OF BUTTERFLY SHAPED LOCKING COMPRESSIO PLATE IN COOMPLEX DISTAL RADIUS FRACTURES. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(6): 665-668. doi: 10.7507/1002-1892.20140147 Copy

1.	姜保國, 張殿英, 傅中國, 等. 橈骨遠端粉碎性骨折及關節內骨折的手術治療. 中華骨科雜志, 2002, 22(2):80-83.
2.	王古衡, 謝仁國, 湯錦波. 上肢骨折發生率和發生特點的臨床資料分析. 中華手外科雜志, 2012, 28(2):95-98.
3.	Willis AA, Kutsumi K, Zobitz ME, et al. Internal fixation of dorsally displaced fractures of the distal part of the radius:a biomechanical analysis of volar plate fracture stability. J Bone Joint Surg (Am), 2006, 88(11):2411-2417.
4.	Wei DH, Raizman NM, Bottino CJ, et al. Unstable distal radial fractures treated with external fixation, a radial column plate, or a volar plate. A prospective randomized trial. J Bone Joint Surg (Am), 2009, 91(7):1568-1577.
5.	Soong M, van Leerdam R, Guitton TG, et al. Fracture of the distal radius:risk factors for complications after locked volar plate fixation. J Hand Surg (Am), 2011, 36(1):3-9.
6.	Souer JS, Ring D, Matschke S, et al. Comparison of functional outcome after volar plate fixation with 2.4-mm titanium versus 3.5-mm stainless-steelplate for extra-articular fracture of distal radius. J Hand Surg (Am), 2010, 35(3):398-405.
7.	Kreder HJ, Hanel DP, McKee M, et al. Consistency of AO fracture classification for the distal radius. J Bone Joint Surg (Br), 1996, 78(5):726-731.
8.	Henry MH. Distal radius fracture:current concepts. J Hand Surg (Am), 2008, 33(7):1215-1227.
9.	Dienst M, Wozasek GE, Seligson D. Dynamic external fixation for distal radius fractures. Clin Orthop Relat Res, 1997, (338):160-171.
10.	Kim JK, Yi JW, Jeon SH. The effect of an acute distal radioulnar joint laxity on outcome after volar plate fixation of a distal radius fracture. J Orthop Trauma, 2013, 27(12):735-739.
11.	白志剛, 聶繼平, 李昶, 等. 不穩定橈骨遠端骨折的手術治療. 中華手外科雜志, 2010, 26(2):76-78.
12.	Rikli DA, Regazzoni P. Fractures of the distal end of the radius treated by internal fixation and early function. A preliminary report of 20 cases. J Bone Joint Surg (Br), 1996, 78(4):588-592.
13.	盛加根, 羅從風, 曾炳芳. 掌側鎖定加壓接骨板(LCP)治療橈骨遠端不穩定骨折. 中華創傷骨科雜志, 2005, 7(7):657-659.
14.	劉軍, 霍維玲, 潘政軍, 等. 掌側鎖定鋼板治療不穩定型老年橈骨遠端骨折的療效. 中國老年學雜志, 2011, 31(24):4916-4917.
15.	陳宣煌, 陳仙英. 掌側T形鎖定接骨板治療AO分型C型橈骨遠端骨折. 中國實用醫刊, 2013, 40(19):80-81.
16.	王明輝, 陸耀剛, 夏勝利, 等. 掌側入路經旋前方肌下插入鎖定鋼板治療橈骨遠端不穩定性骨折. 中華手外科雜志, 2013, 29(4):248-249.
17.	張俊, 尹偉忠, 沈燕國, 等. 掌側T型鎖定鋼板聯合橈骨莖突鋼板治療C型橈骨遠端骨折. 中國修復重建外科雜志, 2012, 26(11):1281-1284.
18.	Boland MR, Spigelman T, Uhl TL. The function of brachioradialis. J Hand Surg (Am), 2008, 33(10):1853-1859.
19.	Cole DW, Ellsaidi GA, Kuzma KR, et al. Distal radioulnar joint instability in distal radius fractures:the role of sigmoid notch and triangular fibrocartilage complex revisited. Injury, 2006, 37(3):252-258.

1. 姜保國, 張殿英, 傅中國, 等. 橈骨遠端粉碎性骨折及關節內骨折的手術治療. 中華骨科雜志, 2002, 22(2):80-83.
2. 王古衡, 謝仁國, 湯錦波. 上肢骨折發生率和發生特點的臨床資料分析. 中華手外科雜志, 2012, 28(2):95-98.
3. Willis AA, Kutsumi K, Zobitz ME, et al. Internal fixation of dorsally displaced fractures of the distal part of the radius:a biomechanical analysis of volar plate fracture stability. J Bone Joint Surg (Am), 2006, 88(11):2411-2417.
4. Wei DH, Raizman NM, Bottino CJ, et al. Unstable distal radial fractures treated with external fixation, a radial column plate, or a volar plate. A prospective randomized trial. J Bone Joint Surg (Am), 2009, 91(7):1568-1577.
5. Soong M, van Leerdam R, Guitton TG, et al. Fracture of the distal radius:risk factors for complications after locked volar plate fixation. J Hand Surg (Am), 2011, 36(1):3-9.
6. Souer JS, Ring D, Matschke S, et al. Comparison of functional outcome after volar plate fixation with 2.4-mm titanium versus 3.5-mm stainless-steelplate for extra-articular fracture of distal radius. J Hand Surg (Am), 2010, 35(3):398-405.
7. Kreder HJ, Hanel DP, McKee M, et al. Consistency of AO fracture classification for the distal radius. J Bone Joint Surg (Br), 1996, 78(5):726-731.
8. Henry MH. Distal radius fracture:current concepts. J Hand Surg (Am), 2008, 33(7):1215-1227.
9. Dienst M, Wozasek GE, Seligson D. Dynamic external fixation for distal radius fractures. Clin Orthop Relat Res, 1997, (338):160-171.
10. Kim JK, Yi JW, Jeon SH. The effect of an acute distal radioulnar joint laxity on outcome after volar plate fixation of a distal radius fracture. J Orthop Trauma, 2013, 27(12):735-739.
11. 白志剛, 聶繼平, 李昶, 等. 不穩定橈骨遠端骨折的手術治療. 中華手外科雜志, 2010, 26(2):76-78.
12. Rikli DA, Regazzoni P. Fractures of the distal end of the radius treated by internal fixation and early function. A preliminary report of 20 cases. J Bone Joint Surg (Br), 1996, 78(4):588-592.
13. 盛加根, 羅從風, 曾炳芳. 掌側鎖定加壓接骨板(LCP)治療橈骨遠端不穩定骨折. 中華創傷骨科雜志, 2005, 7(7):657-659.
14. 劉軍, 霍維玲, 潘政軍, 等. 掌側鎖定鋼板治療不穩定型老年橈骨遠端骨折的療效. 中國老年學雜志, 2011, 31(24):4916-4917.
15. 陳宣煌, 陳仙英. 掌側T形鎖定接骨板治療AO分型C型橈骨遠端骨折. 中國實用醫刊, 2013, 40(19):80-81.
16. 王明輝, 陸耀剛, 夏勝利, 等. 掌側入路經旋前方肌下插入鎖定鋼板治療橈骨遠端不穩定性骨折. 中華手外科雜志, 2013, 29(4):248-249.
17. 張俊, 尹偉忠, 沈燕國, 等. 掌側T型鎖定鋼板聯合橈骨莖突鋼板治療C型橈骨遠端骨折. 中國修復重建外科雜志, 2012, 26(11):1281-1284.
18. Boland MR, Spigelman T, Uhl TL. The function of brachioradialis. J Hand Surg (Am), 2008, 33(10):1853-1859.
19. Cole DW, Ellsaidi GA, Kuzma KR, et al. Distal radioulnar joint instability in distal radius fractures:the role of sigmoid notch and triangular fibrocartilage complex revisited. Injury, 2006, 37(3):252-258.

Chinese Journal of Reparative and Reconstructive Surgery

APPLICATION OF BUTTERFLY SHAPED LOCKING COMPRESSIO PLATE IN COOMPLEX DISTAL RADIUS FRACTURES

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