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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Variable Angle LCP Volar Rim Plate fixation for volar displaced distal radius fracture with volar lunate facet fragment

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  • presenting/speaker Shiro Suzuki - Tokyo Medical and Dental University, Department of Functional Joint Anatomy, Tokyo, Japan
  • Koji Fujita - Tokyo Medical and Dental University, Department of Orhopedic Surgery, Tokyo, Japan
  • Akimoto Nimura - Tokyo Medical and Dental University, Department of Functional Joint Anatomy, Tokyo, Japan

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-833

doi: 10.3205/19ifssh1380, urn:nbn:de:0183-19ifssh13806

Published: February 6, 2020

© 2020 Suzuki et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: The volar locking plate dramatically improved the surgical treatment of the distal radius fractures. However, some fracture patterns remains difficult to treat. The volar shearing fracture with small volar lunate facet fragments is one of fractures to treat with the conventional volar locking plate. Variable Angle LCP Volar Rim Plate (DePuy-Synthes) is designed that can be placed past the watershed line to support the rim fragments. The objective of present study is to report clinical results of Variable Angle LCP Volar Rim Plate fixation for volar displaced distal radius fracture with volar lunate facet fragment.

Methods: Five patients with distal radius fractures were examined. Inclusion criteria were volar displaced fractures with volar lunate facet fragment and the longitudinal size of the fragments were less than 15 mm (mean 11.6mm, range 9.6 - 13.8 mm). The mean age at the time of the surgery was 50.6 (range 32 - 66) years old. The mean postoperative follow up period was 11.4 (range 8 - 16) months. Implants removal were performed in all patients after bone union confirmed by computed tomography. The range of motion, Mayo Writ Score at the final follow up period and complications were evaluated.

Results and Conclusions: Bone union was achieved in all patients without loss of reduction. The mean active extension was 74.4 (range 72 - 80) degrees and active flexion was 70.6.0 (range 68 - 73). The mean Mayo Writ Score was 86.0 (range 80 - 90) points. The complication was a pain or feeling of strangeness at the wrist flexion in four patients. Impingement of plates to lunate or scaphoid were speculated as the cause. The symptoms were improved by implant removal in all patients. The median nerve symptoms or the flexor tendons symptoms were not occurred in any patients, however, intra plate removal operative finding showed the compression of the flexor pollicis longus tendon by the distal end of the plate in one patient.

The Rim plate is useful to support rim fragments and to avoid postoperative displacement because of its high buttress effect. However plate removal must be necessary because of the risk of complications such as flexor tendon problem and plate impingement. Rim plate must be indicated to the rim fractures.