Minimally invasive percutaneous plate osteosynthesis for distal radius fractures with long-segment metadiaphyseal comminution

Abstract

Introduction: Distal radius fractures with both metaphyseal and diaphyseal comminution are commonly encountered injuries due to high-energy trauma. However, effectively treating patients with this disease remains challenging for the surgeon.

Hypothesis: The goal of this study was to evaluate the outcomes of minimally invasive percutaneous plate osteosynthesis (MIPPO) technique for distal radius fractures with long-segment metadiaphyseal comminution.

Material and methods: Nine patients with distal radius fractures involving long-segment metadiaphyseal comminution were treated with MIPPO from June 2011 to May 2012. Radiograph index, the range of motion of the wrist and forearm, grip strength, the Disabilities of the Arm, Shoulder, and Hand (DASH) score were assessed at final follow-up. Additionally, time to bone healing, time to return to work or activity, and postoperative complications were also recorded.

Results: All nine fractures healed by 13±1.3 weeks postoperatively. At an average follow-up of 15.9±3.6 months, the radiographs revealed a mean radial inclination of 18.2±2.7°, a mean volar tilt of 10.7±3.2°, and a radial shortening of 2.3±1.0mm. Nine patients had excellent wrist function according to the DASH score, range of motion, and grip strength. Except one patient experienced delayed healing of the distal incision, no complications occurred. All patients resumed work or activity within 16.2±1.9 weeks.

Discussion: Volar MIPPO is a safe and effective surgical treatment method for distal radius fractures with long-segment metadiaphyseal comminution, with few potential complications.

Type of study/level of evidence: Therapeutic IV.

Keywords: Distal radius fracture; Metadiaphyseal comminution; Minimally invasive plate osteosynthesis; Volar locking compression plate.