A comparison of minimally invasive approach vs conventional approach for volar plating of distal radial fractures

Xu Zhang, Xiangye Huang, Xinzhong Shao, Hongwei Zhu, Jianxin Sun, Xianhui Wang, Xu Zhang, Xiangye Huang, Xinzhong Shao, Hongwei Zhu, Jianxin Sun, Xianhui Wang

Abstract

Background: The aim of this study was to introduce and to evaluate the functional results of volar plating of distal radial fractures through a longitudinal minimally invasive approach.

Methods: From January 2010 to January 2013, 157 patients with distal radial fractures were randomly allocated to group A (n = 83; 49 men, 34 women; mean age: 42 (18-67)) and B (n = 74; 46 men, 28 women; mean age: 41 (22-65)), including type A2, A3, B3, C1, and C2 fractures, based on AO Foundation and Orthopaedic Trauma Association Classification. Patients in group A were treated through a 1.5- to 2-cm longitudinal incision, and patients in group B were treated through the conventional flexor carpi radialis approach. All fractures were treated with a locking volar plate. The functional results were compared with range of motion, grip and pronation strengths for each fracture type.

Results: After a follow-up of 2 years, similar measurements were noted on range of motion and grip strength in both groups. Regarding pronation strength, group A was superior to group B (p < 0.05).

Conclusions: Minimally invasive volar plating of distal radial fractures is a safe and reliable technique, resulting in better pronation function and appearance.

Level of evidence: Level I, Therapeutic study.

Keywords: Distal radial fracture; Pronator quadratus; Volar plating.

Copyright © 2017 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

Figures

Fig. 1
Fig. 1
A. A distal radial fracture on posteroanterior view. B. Lateral view.
Fig. 2
Fig. 2
Consort flow diagram of the groups.
Fig. 3
Fig. 3
A. A 2.5-cm longitudinal incision is made on the radiovolar aspect of the distal forearm. B. Through the small incision, volar plating is accomplished with a 7 cm long angle volar plate inserted beneath the pronator quadratus.
Fig. 4
Fig. 4
A. A posteroanterior radiograph shows reduction and plate positioning. B. Lateral view. C. Incisions are closed.
Fig. 5
Fig. 5
A. Incision appearance and wrist radial deviation 26 months after surgery. B. Ulnar deviation.
Fig. 6
Fig. 6
A. Flexion. B. Extension. C. Supination. D. Pronation.

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