Abstract

SERE, Ignacio et al. Fracturas marginales volares de radio distal: fijación con clavijas adicionales a la placa volar. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2020, vol.85, n.3, pp.197-203. ISSN 1852-7434.  http://dx.doi.org/https://doi.org/10.15417/issn.1852-7434.2020.85.3.977.

Introduction: Wrist fracture management with volar locking plates may be insufficient in fractures with volar marginal fragments distal to the line insertion of the pronator quadratus, the insertion site of important ligaments. Objective: To evaluate the reproducibility and results for the treatment of volar marginal fragment in distal radius fractures with a technique of pin fixation, capturing the fragment and securing them under the distal radius volar locking plate. Materials and Methods: The surgical technique uses one or more pins for the fixation of the volar lunate facet fragment in the distal radius, securing the pins under the locking plate. We initially performed a cadaveric simulation. Then we conducted a retrospective study on 7 patients with distal radius intra-articular fractures and volar marginal fragments distal to the watershed line, treated between September 2014 and February 2015. The average age was 53 years, and the average follow-up was 16 months. Radiographs were obtained in successive controls. Range of motion, grip strength, and 2 functional scores were assessed at discharge. Results: All fractures healed successfully maintaining reduction of the volar marginal fragment. There were no cases of postoperative distal radio ulnar joint instability. Conclusion: Additional fixation of volar marginal fragment in distal radius fractures with bent pins under the plate provides an easy, affordable and adequate alternative to supply the adequate fragment stabilization that plate-alone techniques do not achieve.

Keywords : Volar marginal fractures; distal radius; fixation; pins; volar plates.

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