Evaluation of the coronal malposition of the volar locking plate in the treatment of distal radius fractures

dc.authorid0000-0001-8437-5405
dc.contributor.authorUsta, Emirhan
dc.contributor.authorAkpolat, Ahmet Onur
dc.contributor.authorKahraman, Ahmet Nedim
dc.contributor.authorKara, Adnan
dc.contributor.authorÖç, Yunus
dc.contributor.authorKılınç, Bekir Eray
dc.date.accessioned2022-07-22T08:03:20Z
dc.date.available2022-07-22T08:03:20Z
dc.date.issued2022
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Ortopedi ve Travmatoloji Ana Bilim Dalı
dc.description.abstractBackground and objectives: Literature does not show any studies regarding plate placement problems in the coronal plane of patients with volar plating due to distal radius fracture diagnosis. We aimed to investigate the functional and laboratory results of the coronal malposition of the volar locking plate in patients with distal radius fracture treated with internal fixation. Methods: In this retrospective study, we included patients who had volar plate fixation, were aged between 18 and 80, had no pathological fracture, had a minimum of six months of follow-up, and had the same rehabilitation protocol. We consider the angle subtended on the coronal axis between the distal radius long axis and the distal radius locking plate as coronal malposition. We named the coronal malposition angle the "AYE Angle." Patients with an AYE angle of over 1 degree were evaluated under group 1. Patients with an AYE angle of 0-1 degrees were evaluated under group 2. Radiological parameters were taken from AP-Lateral X-ray views. Superficial University System of Georgia (USG) examinations were applied to detect tendon problems. The DASH and QUICK-DASH scoring systems were used for clinical evaluation. Grip strength was measured with a dynamometer in all patients. All results were compared between the two groups. Results: Thirteen patients were female and 27 patients were male. Nineteen patients who had coronal malposition were added to group 1, while 21 patients who had no coronal malposition were added to group 2. Fifteen patients had normal USG results in group 2, while 18 patients had edema around the flexor pollicis longus (FPL) tendon as a result of USG in group 1. Statistically, a significant difference was detected between the two groups in terms of the amount of tenosynovitis around FPL (p=0.01). A statistically significant relationship was found between USG grading and malposition grading. The study revealed that a higher rate of USG grade 2 was found in patients with malposition grade 2 (90.9%), while a higher rate of USG grade 1 (50%) was observed in patients with malposition grade 1 (p=0.01). A statistically significant difference was not found between Soong grading and USG in terms of the level of tenosynovitis around the FPL tendon. The amount of tenosynovitis detected around the FPL tendon was 62.5% for Soong and grade 0 level, 60.7% for grade 1 level, and 50% for grade 2 level. There was no statistically significant difference between the two groups in the DASH and QUICK-DASH scoring systems (p=0.96). There was no statistically significant difference between the two groups in the grip strength (p=0.52). Conclusion: Coronal plate position in the treatment of the distal radius fracture is important to avoid potential flexor tendon problems. The volar plate position should be adjusted properly both in the coronal and sagittal axes.
dc.identifier.citationUsta, E., Akpolat, A. O., Kahraman, A. N., Kara, A., Öç, Y. ve Kılınç, B. E. (2022). Evaluation of the coronal malposition of the volar locking plate in the treatment of distal radius fractures. Cureus Journal of Medical Science, 14(6). http://doi.org/10.7759/cureus.26444
dc.identifier.doi10.7759/cureus.26444
dc.identifier.issn2168-8184
dc.identifier.issue6
dc.identifier.pmid35915673
dc.identifier.urihttp://doi.org/10.7759/cureus.26444
dc.identifier.urihttps://hdl.handle.net/20.500.12511/9597
dc.identifier.volume14
dc.identifier.wos000822423800011en_US
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakPubMed
dc.institutionauthorKara, Adnan
dc.language.isoen
dc.publisherCureus Inc.
dc.relation.ispartofCureus Journal of Medical Scienceen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsAttribution 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/*
dc.subjectCoronal Malposition
dc.subjectTenosynovitis
dc.subjectFlexor Pollicis Longus
dc.subjectVolar Locking Plate
dc.subjectDistal Radius Fracture
dc.titleEvaluation of the coronal malposition of the volar locking plate in the treatment of distal radius fractures
dc.typeArticle

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