International Journal of Orthopaedics Sciences 2015; 1(2): 19-22

ISSN: 2395-1958
IJOS 2015; 1(2): 19-22
© 2015 IJOS A prospective study of functional & radiological
www.orthopaper.com
Received: 15-05-2015 outcome of management of intra-articular distal radius
Accepted: 16-06-2015
fracture by plating
Dr. S Selvakumar
MS Ortho., Assistant Professor,
Department of Orthopaedics, Dr. S Selvakumar and Dr. L Kumar
Government Mohan
Kumaramangalam Medical
College, Salem, Tamil Nadu, DOI: https://doi.org/10.22271/ortho.2015.v1.i2a.3265
India
Abstract
Dr. L Kumar Aim: To analyze prospectively the functional & radiological outcome of management of intra-articular
MS Ortho., Assistant Professor, distal radius fracture by plating
Department of Orthopaedics, Materials & Methods: About 30 adult patients with intra-articular distal radius fracture admitted to
Government Mohan Government Mohan Kumaramangalam medical college hospital from May 2013 to February 2015 were
Kumaramangalam Medical
included in this study. Post operatively patients were assessed using MAYO score.
College, Salem, Tamil Nadu,
Follow up: All patients had regular follow up every 4 weeks until union occurred after which patients
India
had follow up every 3 months
Results: Low energy fractures in the elderly are linked to favourable functional outcomes, although there
are several complicating factors. The morphological reduction of the distal radius articular surface and
attaining good distal radio ulnar congruity with early mobilisation for early recovery are the important
components of the treatment. According to the Mayo wrist score and other research, our study's 72% of
VLCP patients had very good results.
Conclusion: We conclude from our study Following the foregoing debate, it has been determined that
the use of a volar plate and screw system for fracture fixation is a preferable way to keep fracture
fragments from collapsing, even in severely comminuted, unstable, and osteoporotic bones. Patients who
have an unstable, dorsally or vertically misplaced The radiographic result of the intraarticular radius
fracture was excellent to good, when used with a volar locking plate with a fixed angle. However, further
research is required to confirm our findings over time.

Keywords: Volar plating, mayo score, modified henry’s approach

1. Introduction
 Depending on factors such as age, transfer of energy, mechanism of injury and bone
quality the distal end of the radius is subjected to different types of fractures, the wrist also
can suffer substantial ligamentous injury causing instability to the carpus or distal radio-
ulnar joint. These injuries are easily missed because the x-rays may look normal.
 The motivation is frequently the desire for distal radius anatomical restoration of distal
radio-ulnar is shorter by more than 2 mm at the distal radio-ulnar joint, dorsal tilt of more
than 10 degrees and dorsal translation of more than 30 per cent are likely to lead to a poor
outcome and hence early correction should be Considered.
 The indications may vary according on the patient, their needs, the type of fracture, and
other factors. It is crucial to take into account the variables that may predict fracture
instability or functional outcome when planning treatment because the main objective of
therapy is to restore maximum function to the hand and wrist.

Aim of the study

Correspondence Author;
Functional & radiological outcome of management of intra-articular distal radius fracture by
Dr. S Selvakumar plating
MS Ortho., Assistant Professor,
Department of Orthopaedics, Materials and Method
Government Mohan  Study Design: Prospective study
Kumaramangalam Medical  Period Of Study: May 2013 to February 2015
College, Salem, Tamil Nadu,  Sample Size: 30
India
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International Journal of Orthopaedics Sciences

Classification radialis, Identify the radial artery radially and the tendon of
flexor carpi radialis ulnarly
In order to see the pronator, the flexor carpi radialis tendon is
retraced ulnarly.

Fig 1: AO classification

Inclusion criteria
16 to 60years Fig 3: Intraoperative image
 AO ‘C’ fractures
 Failure of conservative treatment Along the line of the skin incision pronator quadratus is
 Unacceptable reduction after at least one attempt at closed incised to reveal the volar aspect of the distal radius By
reduction manipulating k-wires, the fracture reduction done. It is
possible to maintain reduction temporarily.
Exclusion criteria The suitable plate with Applying 3.5 cortical screws and 4mm
 Skeletal immaturity cancellous screws. fluoroscope' examination of screw size to
 Severe open or delayed fracture where ORIF is avoid problems later complications. Often sutured to
contraindicated encompass the distal end of the pronator quadratus plate to
 Delay of >14 days after injury stop the tendon from being irritated.
 Isolated radial styloid The plate has two purposes:
 Unwilling patients The distal fragment buttressing and keeps the metaphyseal
reduction in place.
Operative technique
 Anaesthesia – GA/RA Mayo wrist score
 Supine Position.
Palpate the styloid process of the radius. It is the most distal
part of the lateral side of the radius. Then move in an ulna
direction to palpate the tendon of flexor carpi radialis which is
thick and immobile. The flexor carpi radialis muscle and
tendon lie radial to the palmaris longus muscle at the level of
the wrist and just to the ulnar side of the radial pulse.

Fig 2: Modified Henry's Approach Post-operative protocol

The mean follow-up was 9 months, with a range of 3 to 14
Incise the deep fascia overlying the tendon of flexor carpi months. 20 patients received ongoing care.
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International Journal of Orthopaedics Sciences

UNION: There was good union among all the patients. There Conclusion
were 14 unions on average. We conclude from our study Following the foregoing debate,
16 instances had healed by 12 weeks, with a range of 10 to 18 it has been determined that the use of a volar plate and screw
weeks. system for fracture fixation is a preferable way to keep fracture
The remaining 14 instances took longer to complete. fragments from collapsing, even in severely comminuted,
unstable, and osteoporotic bones.
Table 1: Mayo functional score Patients who have an unstable, dorsally or vertically misplaced
Excellent 12 The radiographic result of the intraarticular radius fracture was
Good 7 excellent to good, when used with a volar locking plate with a
Fair 8 fixed angle.
Poor 3 However, further research is required to confirm our findings
over time.

Conflict of Interest
Not available

Financial Support
Not available

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How to Cite This Article

Selvakumar S, Kumar L. A prospective study of functional &
radiological outcome of management of intra-articular distal radius
fracture by plating. International Journal of Orthopaedics Sciences.
2015;1(2):19-22.

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