Frontiers in surgery · 2026
Scar and short-term outcomes after transverse versus modified Henry incisions for volar plating of selected distal radius fractures: a retrospective comparative study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Zhao Xing, Gong Boxiong, Yang Jian, Shang Feng, Zhou Xiaorui, Wang Xi, Zhao Meng, Xu Shengkang
Аннотация
BACKGROUND: Volar locking plate fixation is widely used for distal radius fractures (DRFs), but visible scarring and incision-related morbidity remain important patient-centred concerns. This exploratory retrospective study compared scar outcomes and selected short-term clinical outcomes between a single palmar lateral transverse incision and the modified Henry approach in surgically treated DRFs selected for limited volar exposure.
METHODS: This retrospective comparative study included 77 of 86 potentially eligible patients with DRFs who underwent volar locking plate fixation between January 2016 and December 2024; nine patients were excluded because of loss to follow-up and/or incomplete outcome data. Thirty-two patients were treated through a single transverse incision, and 45 through the modified Henry approach. Outcomes included tourniquet time, incision length, Lidström radiographic grade, DASH score, POSAS at final follow-up, and complications. Analyses were unadjusted, and Holm correction was applied across seven outcome comparisons.
RESULTS: No transverse-incision procedure required incision extension or conversion to the modified Henry approach, and no major complication occurred. No statistically significant between-group differences were observed in follow-up duration, tourniquet time, dichotomised Lidström grade, or DASH score (all unadjusted P > 0.05). The transverse-incision group had shorter incisions (P < 0.001; Holm-adjusted P < 0.007) and lower PSAS scores (P = 0.002; Holm-adjusted P = 0.012). The OSAS difference was significant before, but not after, multiplicity correction (unadjusted P = 0.032; Holm-adjusted P = 0.160).
CONCLUSIONS: In this selected cohort, the transverse incision was associated with shorter incisions and lower patient-reported scar scores. The observer-reported scar difference did not remain significant after multiplicity correction. These findings suggest that the transverse incision may offer a scar-related advantage in appropriately selected fractures. The retrospective design and differences in fracture complexity warrant cautious interpretation and prospective confirmation.
METHODS: This retrospective comparative study included 77 of 86 potentially eligible patients with DRFs who underwent volar locking plate fixation between January 2016 and December 2024; nine patients were excluded because of loss to follow-up and/or incomplete outcome data. Thirty-two patients were treated through a single transverse incision, and 45 through the modified Henry approach. Outcomes included tourniquet time, incision length, Lidström radiographic grade, DASH score, POSAS at final follow-up, and complications. Analyses were unadjusted, and Holm correction was applied across seven outcome comparisons.
RESULTS: No transverse-incision procedure required incision extension or conversion to the modified Henry approach, and no major complication occurred. No statistically significant between-group differences were observed in follow-up duration, tourniquet time, dichotomised Lidström grade, or DASH score (all unadjusted P > 0.05). The transverse-incision group had shorter incisions (P < 0.001; Holm-adjusted P < 0.007) and lower PSAS scores (P = 0.002; Holm-adjusted P = 0.012). The OSAS difference was significant before, but not after, multiplicity correction (unadjusted P = 0.032; Holm-adjusted P = 0.160).
CONCLUSIONS: In this selected cohort, the transverse incision was associated with shorter incisions and lower patient-reported scar scores. The observer-reported scar difference did not remain significant after multiplicity correction. These findings suggest that the transverse incision may offer a scar-related advantage in appropriately selected fractures. The retrospective design and differences in fracture complexity warrant cautious interpretation and prospective confirmation.