J Korean Fract Soc.  2015 Jan;28(1):8-16. 10.12671/jkfs.2015.28.1.8.

Treatment of the Communited Distal Radius Fracture Using Volar Locking Plate Fixation with Allogenic Cancellous Bone Graft in the Elderly

• Hong JK
• Shin CH

• KMID: 1774091
• DOI: http://doi.org/10.12671/jkfs.2015.28.1.8

Abstract

PURPOSE
We studied results of the communited distal radius fracture treated with allogenic cancellous bone graft and volar locking plate in the elderly.
MATERIALS AND METHODS
We studied 29 cases of communited distal radius fracture treated with allogenic cancellous bone graft and volar locking plate from April 2009 to April 2013. Fracture was classified according to AO/OTA classification. Postoperative clinical evaluation was performed with measurement of wrist range of motion (ROM) at last follow-up, modified Mayo wrist scoring system (MMWS), and visual analogue pain scale (VAS). Radiologic evaluation was performed with measurement of radial length on immediate postoperation and last follow-up, radial inclination, volar tilt and ulnar variance checked at the last follow-up using Sarmiento criteria.
RESULTS
Using the MMWS, 13 cases were classified as 'good', 10 'fair', and 5 'normal'. The average wrist ROM was 88.5% for flexion, 92.2% for extension, 90.5% for adduction, and 94.0% for abduction. The average VAS was 1.7. On the last follow-up, average radius length, radial inclination and volar tilt did not show statistically significant improvement (p>0.05) compared to immediate post operation measurements, and according to Sarmiento criteria, 5 cases were classified as 'good', 14 'fair', and 7 'normal'.
CONCLUSION
Treatment of severe communited distal radius fracture accompanied by bone defect with volar locking plate and allogenic cancellous bone graft is a satisfying and effective treatment method in the elderly.

Keyword

Distal radius fracture; Allogenic Cancellous Bone Graft; Volar Locking Plate

MeSH Terms

Aged*
Classification
Follow-Up Studies
Humans
Pain Measurement
Radius
Radius Fractures*
Range of Motion, Articular
Transplants*
Wrist

Figure

• 

  Fig. 1 A 71-year-old woman with an AO/OTA classification C3.2 type fracture. (A) Preoperative anteroposterior and lateral radiographs. (B) Preoperative 3-dimensional computed tomography. (C) Piled up allogenous cancellous bone chip at bone defect lesion (arrow). (D) Postoperative anteroposterior and lateral radiographs. (E) Postoperative 12 months anteroposterior and lateral radiographs.

• 

  Fig. 2 A 78-year-old woman with an AO/OTA classification C3.3 type fracture. (A) Preoperative anteroposterior and lateral radiographs. (B) Preoperative 3-dimensional computed tomography. (C) Piled up allogenous cancellous bone chip at bone defect lesion (arrow). (D) Postoperative anteroposterior and lateral radiographs. (E) Postoperative 15 months anteroposterior and lateral radiographs.

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