J Korean Fract Soc.  2020 Jan;33(1):38-42. 10.12671/jkfs.2020.33.1.38.

Tension Band Wiring Technique for Distal Radius Fracture with a Volar Articular Marginal Fragment: Technical Note

• Jeon N
• Oh JK
• Cho JW
• Kim Y

• KMID: 2468673
• DOI: http://doi.org/10.12671/jkfs.2020.33.1.38

Abstract

Most distal radius fractures are currently being treated with anterior plating using anatomical precontoured locking compression plates via the anterior approach. However, it is difficult to fix the volar articular marginal fragment because these anatomical plates should be placed proximally to the watershed line. There were just a few methods of fixation for this fragment on medical literature. Herein, we introduced a tension band wiring technique for fixation of a volar articular marginal fragment in the distal radius.

Keyword

Distal radius; Articular marginal fracture; Anterior approach; Tension band wiring

MeSH Terms

Radius Fractures*
Radius*

Figure

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  Fig. 1 (A) Volar articular marginal fragment (circles with the dotted line) with a comminuted metaphyseal fracture of the distal radius on plain radiography. (B) Three-dimensional computed tomography scan also shows the volar articular marginal fragment.

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  Fig. 2 (A) Two K-wires were inserted from the distal edge of the volar articular marginal fragment to the posterior cortex proximally and posteriorly after reduction with pointed forceps through the modified Henry approach. (B) The position of two K-wires was checked on the anteroposterior and lateral view of the C-arm image.

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  Fig. 3 Tension band wiring for the volar articular marginal fragment after plating.

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  Fig. 4 Radiologic union (A) and near full fuctional recovery (B) were achieved at postoperative 6 weeks.

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  Fig. 5 (A) The simple volar articular marginal fragment of the distal radius on plain radiography. (B) Three-dimensional computed tomography scan also shows more clearly the volar articular marginal fragment.

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  Fig. 6 (A) Immediate postoperative radiograph. Protrusion of the K-wire was seen on the oblique view (circle with the dotted line). (B) Complete union was seen on the postoperative 1-year X-ray. (C) Deficit of wrist flexion still remained due to protrusion of the K-wire at postoperative 1-year follow up. (D) Postoperative X-ray after implant removal. (E) The deficit of wrist flexion was full recovered after removal of the implant.

Reference

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