Acta orthopaedica et traumatologica turcica · 2016
A new complication in volar locking plating of the distal radius: longitudinal fractures of the near cortex.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sügün Tahir Sadık, Gürbüz Yusuf, Özaksar Kemal, Toros Tulgar, Bal Emin, Kayalar Murat
Аннотация
OBJECTIVE: The purpose of this study was to document a new complication in volar locking plating of the distal radius.
METHODS: Between January 2007 and January 2014, 223 patients were identified from the department's surgical database with retrospective chart and radiographic review. Sixty-eight patients were over 60 years of age. All fractures were operated with Acu-Loc® (Acumed, Hillsboro, OR, USA) wrist volar locking plating systems. Longitudinal fracture lines (LFL) beneath volar plate-extending proximal shafts were documented. Correlations between age groups and LFLs were investigated. Radiographs with LFLs were assessed at final follow-up for the following parameters: volar tilt, radial inclination and radial length.
RESULTS: Twenty-eight of 68 patients over age of 60 years had LFLs. Correlation was significant for age groups (p<0.05). The effect of these fracture lines on radiographic parameters was not significant (p>0.05).
CONCLUSION: Surgeons should be aware of the complications that may occur with volar locking plates. Understanding of potential complications and their results are important. As a result of aging, thinning, and weakening, the near cortex may become more brittle. When the plate is reduced on the bone with a nonlocking screw, the conical head of diaphyseal locking screws can extend over plate thickness and penetrate the near cortex, acting as a screwing wedge. Additional divergent configuration may promote this effect and crack the cortex.
METHODS: Between January 2007 and January 2014, 223 patients were identified from the department's surgical database with retrospective chart and radiographic review. Sixty-eight patients were over 60 years of age. All fractures were operated with Acu-Loc® (Acumed, Hillsboro, OR, USA) wrist volar locking plating systems. Longitudinal fracture lines (LFL) beneath volar plate-extending proximal shafts were documented. Correlations between age groups and LFLs were investigated. Radiographs with LFLs were assessed at final follow-up for the following parameters: volar tilt, radial inclination and radial length.
RESULTS: Twenty-eight of 68 patients over age of 60 years had LFLs. Correlation was significant for age groups (p<0.05). The effect of these fracture lines on radiographic parameters was not significant (p>0.05).
CONCLUSION: Surgeons should be aware of the complications that may occur with volar locking plates. Understanding of potential complications and their results are important. As a result of aging, thinning, and weakening, the near cortex may become more brittle. When the plate is reduced on the bone with a nonlocking screw, the conical head of diaphyseal locking screws can extend over plate thickness and penetrate the near cortex, acting as a screwing wedge. Additional divergent configuration may promote this effect and crack the cortex.