Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V... · 2018
Percutaneous K-wires vs palmar locking plate fixation for different types of distal radial fractures: a comparison of the outcomes of two methods to controll our guidelines.
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Zyluk Andrzej, Janowski Piotr, Szlosser Zbigniew, Puchalski Piotr
Аннотация
UNLABELLED: The objective of the study was a comparison of the outcomes of K-wire vs plate fixation for distal radial fractures used according to the proposed institutional algorithm. Fracture configurations A2, A3, B1, B2, C1 and some C2 were operated on with K-wire pinning, whereas B3 and some B2, C3 and some C2 were with locking palmar-plate fixation.
PATIENTS AND METHODS: Four hundred and sixty-seven patients were non-randomly allocated for either K-wire (n = 363) or palmarplate (n = 104) fixation. The results were assessed at 3 and 12 months by the same outcome measures.
RESULTS: At the 3-month assessment, statistically significant differences in grip strength and the DASH scores were noted in favour of the plate-fixation group. At the 12-month assessment, statistically significant differences were observed in the wrist palmar and dorsal flexion, favouring the plate-fixation group. Statistically significant differences were noted in radiological measures of the palmar tilt and the ulnar variance, both favouring the plate-fixation method. Meaningful secondary dislocations were noted in ten patients, all in the K-wire-fixation group.
CONCLUSION: We conclude that palmar locking plate fixation in even more severe fractures leads to better radiological and clinical outcomes than K-wire fixation in less severe fractures.
PATIENTS AND METHODS: Four hundred and sixty-seven patients were non-randomly allocated for either K-wire (n = 363) or palmarplate (n = 104) fixation. The results were assessed at 3 and 12 months by the same outcome measures.
RESULTS: At the 3-month assessment, statistically significant differences in grip strength and the DASH scores were noted in favour of the plate-fixation group. At the 12-month assessment, statistically significant differences were observed in the wrist palmar and dorsal flexion, favouring the plate-fixation group. Statistically significant differences were noted in radiological measures of the palmar tilt and the ulnar variance, both favouring the plate-fixation method. Meaningful secondary dislocations were noted in ten patients, all in the K-wire-fixation group.
CONCLUSION: We conclude that palmar locking plate fixation in even more severe fractures leads to better radiological and clinical outcomes than K-wire fixation in less severe fractures.