Open Access, Peer-reviewed, Quarterly
pISSN 1225-1682
eISSN 2287-9293
    J Korean Fract Soc. 2015 Jul;28(3):178-185. Korean.
    Published online Jul 22, 2015.
    https://doi.org/10.12671/jkfs.2015.28.3.178
    Copyright © 2015 The Korean Fracture Society. All rights reserved.
    Original Article

    Outcomes of Severe Comminuted Distal Radius Fractures with Pronator Preserving Approach

    Seung Hyun Cho, M.D., Hong Gi Park, M.D., Deuk Soo Jun, M.D., Jae Ang Sim, M.D., Ph.D, Young Hak Roh, M.D., Yong-Cheol Yoon, M.D. and Jong-Ryoon Baek, M.D., Ph.D
      • Department of Orthopedic Surgery, Gachon University Gil Medical Center, Incheon, Korea.
    • Address reprint requests to: Jong-Ryoon Baek, M.D., Ph.D. Department of Orthopedic Surgery, Gachon University Gil Medical Center, 21 Namdong-daero 774beon-gil, Namdong-gu, Incheon 405-760, Korea. Tel: 82-32-460-3384, Fax: 82-32-468-5437, Email: baekjr@gilhospital.com
    Received June 14, 2015; Revised June 21, 2015; Accepted June 22, 2015.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    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 20.5°; the average volar tilt, 7.57°; 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.

    Keywords
    Distal radius fracture; Pronator-preserving approach

    Figures

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

    Fig. 2
    Preoperative 3-dimensional computed tomography image.

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

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

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

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

    Notes

    Financial support:None.

    Conflict of interest:None.

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    MeSH Terms
    Classification
    Female
    Follow-Up Studies
    Humans
    Male
    Palmar Plate
    Radius Fractures*
    Wrist
    Metrics
    Share
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