Abstract

CLEMBOSKY, Gabriel; GOMEZ RODRIGUEZ, Gustavo L; PERRONE, Juan Martín  and  GOMEZ, Diego J. Fractura de radio distal: abordaje mininvasivo con preservación del pronador cuadrado. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2015, vol.80, n.3, pp.150-157. ISSN 1852-7434.

Objective: To describe and analyze a volar locking plate technique for distal radius fractures with pronator quadratus preservation. Methods: We retrospectively reviewed 24 patients who underwent minimally invasive approach (16 women, 8 men; mean age 65 years). Twelve fractures were type A, 7 type B and 5 type C. The surgical technique involves making an incision of 25 mm and deepened to expose the pronator quadratus. Afterwards, a distal edge dissection of the pronator quadratus is performed in order to introduce the volar locking plate under the muscle. Distal screws are placed under direct vision and proximal screws are placed percutaneously. Postoperative evaluation included clinical, functional and radiological analyses. Results: At last control, all patients had clinical and radiographic signs of bone healing. The average score on the DASH scale was 4.8 points. Postoperative average volar tilt was 14.3° and the average radial inclination was 26.3°. There were no complications related to the fracture, implant or surgical wound in the postoperative controls. Conclusions: Although we did not obtain better results with this technique than with the conventional one, and there is no literature available which demonstrates that the minimally invasive technique is superior, we believe that the fact of getting similar results with both approaches justifies carrying out this technique with pronator quadratus preservation, especially in patients concerned about the cosmetic appearance of the scar.

Keywords : Volar locking plate; Minimally invasive technique; Pronator quadratus preservation; Distal radius fracture.

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