Joint diseases and related surgery · 2025
Correction of volar tilt using the lift technique with fixed-angle volar locking plate in distal radius fractures.
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Öztürk Ahmet Alperen
Аннотация
OBJECTIVES: The aim of this study is to evaluate the radiological effectiveness of restoring volar tilt in dorsally displaced distal radius fractures using the lift technique performed with a fixedangle volar locking plate.
PATIENTS AND METHODS: Between January 2023 and February 2025, a total of 14 patients (5 males, 9 females; median age: 46.9 years; range, 32 to 72 years) with dorsally displaced intraarticular or extra-articular distal radius fractures who underwent fixation with a fixed-angle volar plate using the visually estimated lift technique were retrospectively analyzed. Fractures were classified according to the AO classification. Pre-lift and post-lift volar tilt angles as well as plate-shaft angles were measured from fluoroscopy images, and control volar tilt angles were measured from radiographs. Actual angular correction was defined as the difference between pre-lift and post-lift volar tilt angles.
RESULTS: Fracture types were AO Type A in nine patients, AO Type C in four patients, and AO Type B in one patient. The median volar tilt angle at the time of fracture was -24.9° (range, -4° to -56°). Following traction and reduction maneuvers, the median pre-lift volar tilt was -4.9° (range, -20° to 4°), the median post-lift volar tilt was 9.5° (range, 0° to 15°), and the median volar tilt at follow-up was 9.4° (range, 1° to 16°). Plate-shaft angles ranged from 6° to 25° (median: 14.2°). Actual angular correction ranged from 5° to 25°. In 11 cases (78.5%), intraoperative correction achieved the target range of 5° to 15°. In three cases (15.4%), volar tilt correction was insufficient, with final values of 0°, 3°, and 4°. The ratio (R) of actual angular correction to theoretical angular correction was approximately 0.67.
CONCLUSION: The lift technique using a fixed-angle volar plate is a reliable and effective method for intraoperative correction of volar tilt in dorsally displaced distal radius fractures. The technique provides a valuable alternative, particularly in cases where manual reduction fails to achieve sufficient volar tilt restoration.
PATIENTS AND METHODS: Between January 2023 and February 2025, a total of 14 patients (5 males, 9 females; median age: 46.9 years; range, 32 to 72 years) with dorsally displaced intraarticular or extra-articular distal radius fractures who underwent fixation with a fixed-angle volar plate using the visually estimated lift technique were retrospectively analyzed. Fractures were classified according to the AO classification. Pre-lift and post-lift volar tilt angles as well as plate-shaft angles were measured from fluoroscopy images, and control volar tilt angles were measured from radiographs. Actual angular correction was defined as the difference between pre-lift and post-lift volar tilt angles.
RESULTS: Fracture types were AO Type A in nine patients, AO Type C in four patients, and AO Type B in one patient. The median volar tilt angle at the time of fracture was -24.9° (range, -4° to -56°). Following traction and reduction maneuvers, the median pre-lift volar tilt was -4.9° (range, -20° to 4°), the median post-lift volar tilt was 9.5° (range, 0° to 15°), and the median volar tilt at follow-up was 9.4° (range, 1° to 16°). Plate-shaft angles ranged from 6° to 25° (median: 14.2°). Actual angular correction ranged from 5° to 25°. In 11 cases (78.5%), intraoperative correction achieved the target range of 5° to 15°. In three cases (15.4%), volar tilt correction was insufficient, with final values of 0°, 3°, and 4°. The ratio (R) of actual angular correction to theoretical angular correction was approximately 0.67.
CONCLUSION: The lift technique using a fixed-angle volar plate is a reliable and effective method for intraoperative correction of volar tilt in dorsally displaced distal radius fractures. The technique provides a valuable alternative, particularly in cases where manual reduction fails to achieve sufficient volar tilt restoration.