抄録
It is difficalt to maintain reduction of the fracture during conservative treatment for intra-articular or palmar displaced fractures of distal radius. Therefore, various surgical treatments such as percutaneous pinning, external fixation, and plate fixation were developed. In this study, we examined the effect of palmar-side plate fixation for these fractures.
Ten patients (2 men and 8 women) with a mean age of 58 years at the time of the injury (range, 31-74 years) were included in this study. The follow up after the operation ranged from 5.5 to 20 months (mean, 12 months). The type of fracture was classified according to Saito’s classification (one sinple Smith’s fracture, five comminuted Smith’s fracture, two comminuted Colles’ fracture and two palmar Barton · chauffeur’s fracture). All the patients had internal fixation using a plate and screws via the palmar approach. 4 patients were added Kirschner wire fixation and 6 patients were grafted β-tricalcium phosphate for bone defect. In 9 of the 10 cases, good reduction according to radiographic parameters including volar tilt,radial inclination, and ulnar variance was obtained at the time of the surgery,and was maintained during the follow up period. In one elderly patient with osteoporosis, the volar tilt and ulnar variance were not maintained. According to the evaluation criteria of Saito, there were 4 excellent, 5 Good, and one fair result. Patients with fair results had contracture of fingers and wrist joint in the post operative period.
We concluded that palmar plate fixation for intra-articular or palmar displaced fractures of the distal radius was a useful surgical procedure in this case series, although postoperative reduction was not maintained in one elder patient with osteoporosis.
