J Korean Fract Soc.  2008 Oct;21(4):334-340. 10.12671/jkfs.2008.21.4.334.

Dorsal Plating for Distal Radius Fracture

• Song SW

• KMID: 1480925
• DOI: http://doi.org/10.12671/jkfs.2008.21.4.334

Abstract

No abstract available.

MeSH Terms

Radius
Radius Fractures

Figure

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  Fig. 1 (A) The zigzag midline incision over the dorsal wrist joint, centered on Lister tubercle, was designed. (B) The entire extensor retinaculum was divided into the distal and proximal halves, and the 3rd extensor compartment was opened. The 2nd and 4th extensor compartments were dissected. (C) Fracture site was reduced, (D) and temporarily fixed with K-wires. After the confirmation of proper reduction "T"-plate was fixed. (E) The half of extensor retinaculum was used to cover the transverse part of the plate, protecting the extensor tendons from the plate and screws. (F) The other half of extensor retinaculum was used to cover extensor tendon like as the original function of retinaculum.

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  Fig. 2 (A) After the union the patients are advised to remove the plate within 6 months to prevent the possible extensor tendon injury. Note the intact extensor tendons over the plate. (B) After the removal of screws, (C) and plate. Over and under the plate there is some thick fibrous tissue protecting the extensor tendons from injury.

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  Fig. 3 (A) Left distal radius and ulnar styloid process were fractured in 74-year old female patient. (B) Dorsal plating and autogenous iliac bone graft were done for distal radius, and K-wires were inserted into the distal ulna. (C) Thirteen months after the operation the plate and screws were removed without any complications to the extensor tendons.

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  Fig. 4 (A) Sixty-nine year old female patient had broken her right wrist, with severe intraarticular fracture of distal radius. (B) Combined volar and dorsal plating were done to gather up the burst fracture fragments, and external fixation to reduce compressive pressure on the radial articular surface. (C) Seven weeks after the operation external fixator was removed. (D) Five months after the operation removal of plates and extensor tenolysis were done. (E) Twenty months after the operation. There is no evidence of post-traumatic arthritis and soft tissue complications.

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  Fig. 5 Low profile plates for dorsal plating. (A) Forte plate® (Zimmer, Warsaw, IN, USA) is thinner than the conventional AO plate, and the screw head sinks into the screw hole. (B) Pi (π) plate® (Synthes, Paoli, PA) is thin and easily malleable to adapt to the complicated dorsal surface of distal radius. Left or right preference can be chosen. (C) Lister tubercle can be saved. (D) Trimed System® (Trimed, Valencia, CA) was applied to the severely comminuted distal radius fracture. (E) Trimed and 2.4-mm AO plate (Synthes, Paoli, PA) import the concept of "column" from Melone's classification of comminuted intraarticular fracture of distal radius, and give the opportunity to fix each fragment with specifically designed small plates.

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