Jnl Wrist Surg 2019; 08(01): 018-023
DOI: 10.1055/s-0038-1667305
Scientific Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Minimally Invasive Plate Osteosynthesis for Extra-articular Distal Radius Fracture in Postmenopausal Women: Longitudinal versus Transverse Incision

Chloé Galmiche
1  Department of Hand Surgery, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg, Illkirch, France
,
Gustavo Gómez Rodríguez
2  Centro Artro, Clinic of the Hand of Buenos Aires, British Hospital of Buenos Aires, Buenos Aires, Argentina
,
Fred Xavier
3  Department of Spine Surgery, QEII Health Sciences Centre – Halifax Infirmary, Dalhousie University, Halifax, Nova Scotia, Canada
,
Yuka Igeta
4  Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan
,
Juan José Hidalgo Diaz
1  Department of Hand Surgery, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg, Illkirch, France
,
Philippe Liverneaux
1  Department of Hand Surgery, University Hospital of Strasbourg, Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg, Illkirch, France
› Author Affiliations
Further Information

Publication History

20 November 2017

15 June 2018

Publication Date:
07 August 2018 (online)

Abstract

Background This work aimed to compare two mini-invasive palmar approaches (longitudinal and transverse) to osteosynthesize fractures of the distal radius. The main hypothesis was that the longitudinal technique gave smaller incisions. The secondary hypothesis was that the longitudinal technique would be better for the recovery of pain, functional scores, strength, and mobility.

Materials and Methods The series included 30 extra-articular distal radius fractures in 30 patients (average age: 74 years) fixed with volar locking plate using a mini-invasive technique. Fifteen of these patients had a single longitudinal surgical approach (Group I), and 15 had a transverse approach that was completed with a longitudinal incision for the proximal screws (Group II).

Results The combined average incision size was 14.73 mm in Group I and 19.8 mm in Group II. After 6 months, the pain was on average 1.4/10 (Group I) and 0.46/10 (Group II), the quick Disability of the Arm, Shoulder, and Hand was 13.63/100 (Group I) and 2.8/100 (Group II), Patient-Related Wrist Evaluation was 11.8/100 (Group I) and 5.97/100 (Group II), grip strength was 81.06% (Group I) and 72.13% (Group II), flexion was 88.13% (Group I) and 75% (Group II), extension was 86% (Group I) and 64.6% (Group II), ulnar inclination was 89% (Group I) and 78.67% (Group II), radial inclination was 89.73% (Group I) and 79.93% (Group II), pronation was 96.67% (Group I) and 81.46% (Group II), and supination was 91.93% (Group I) and 79.87% (Group II).

Clinical Relevance The longitudinal technique gave smaller incisions than the transverse technique. Among the secondary hypotheses, all the variables were better with the longitudinal technique, except the pain, although without any significant difference.