J Korean Fract Soc.  2015 Jul;28(3):178-185. 10.12671/jkfs.2015.28.3.178.

Outcomes of Severe Comminuted Distal Radius Fractures with Pronator Preserving Approach

• Cho SH
• Park HG
• Jun DS
• Sim JA
• Roh YH
• Yoon YC
• Baek JR

• KMID: 2184414
• DOI: http://doi.org/10.12671/jkfs.2015.28.3.178

Abstract

PURPOSE
We investigate the outcomes of treatment of patients with severe comminuted distal radius fractures with volar plate fixation using a pronator-preserving approach.
MATERIALS AND METHODS
Fourteen patients with severe comminution of the distal radius fractures for whom anatomical reduction of the fractures was deemed difficult to achieve with traditional approaches were enrolled. The gender ratio was 8 males to 6 females, and the average age of the patients was 64.9 years. According to the AO/OTA classification of fractures, 2 patients had 23-A3 fractures, 7 patients had 23-C2, and 5 patients had 23-C3. Radial length, radial inclination, and volar tilt were measured for radiologic evaluation. Modified Mayo wrist score (MMWS) was used for clinical outcome.
RESULTS
Bony union was achieved in all 14 patients without signs of complications. The average time-to-union was 4.3 months (3-6 months). The radiological findings at the final follow-up were as follows: the average radial inclination was 20.5degrees; the average volar tilt, 7.57degrees; and the average radial length, 11.8 mm. At the final follow-up, the results of the MMWS were 'Fair' in 1 patient, 'Good' in 4, and 'Excellent' in 9.
CONCLUSION
We propose that a pronator-preserving approach is an effective treatment for severe comminuted distal radius fracture.

Keyword

Distal radius fracture; Pronator-preserving approach

MeSH Terms

Classification
Female
Follow-Up Studies
Humans
Male
Radius Fractures*
Palmar Plate
Wrist

Figure

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  Fig. 1 A 55-year-old male patient presented with a severely comminuted fracture of the distal radius.

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  Fig. 2 Preoperative 3-dimensional computed tomography image.

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  Fig. 3 A pronator-preserving approach was used as the surgical intervention.

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  Fig. 4 The immediate postoperative photograph shows a successful reduction of the fracture.

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  Fig. 5 A radiographic image showing a successful bony union at the final follow-up.

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  Fig. 6 The range of motion of the wrist was normal and the modified Mayo wrist score score was 'excellent'.

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