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J Wrist Surg 2023; 12(03): 232-238
DOI: 10.1055/s-0042-1749162
Procedure

Three Column Fixation Through a Single Incision in Distal Radius Fractures

Giannis Kotsalis 
1   First Department of Orthopedics, General Hospital of Athens G. Gennimatas, Greece
,
Georgios Kotsarinis
2   Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, United Kingdom
,
Maria Ladogianni
3   Department of Upper Limb and Microsurgery , KAT General Hospital, Athens, Greece
,
Emmanouil Fandridis
3   Department of Upper Limb and Microsurgery , KAT General Hospital, Athens, Greece
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Abstract

Purpose The purpose of this study was to evaluate the clinical and functional results of 67 patients with distal radius fracture (DRF), treated with a modified surgical technique that allows three-column fixation through the same palmar approach.

Patients and Methods Between 2014 and 2019, we treated 67 patients using a particular surgical technique. All patients suffered DRF, classified using the universal classification system. Two different intervals were developed palmary: the first ulnarly to the flexor carpi radialis tendon for direct visualization of the distal radius and the second one radially to the radial artery for direct visualization of the styloid process. An anatomic volar locking compression plate was applied to all patients. The radial styloid process was fixed and stabilized either with Kirschner-wires or an anatomic plate through the same incision. Functional results were evaluated based on the Disabilities of the Arm, Shoulder and Hand and Mayo wrist scores. Range of motion and grip strength of the injured wrist were statistically compared with the opposite side.

Results The mean follow-up was 47 months (13–84). All fractures were united, and all patients recovered to the preinjury level of activity. The mean flexion–extension range was 73.8° to 55.2° and the supination–pronation range 82.8° to 67°. No infection or nonunion occurred. No major complications were reported.

Conclusion Open reduction and internal fixation, under specific indications, is the best treatment option in DRF. The described technique provides excellent visualization to the distal radius surfaces and allows the internal fixation of the radial columns through the same skin incision. Therefore, it can constitute an efficient choice in the treatment armamentarium of DRF.

Keywords

distal radius - palmar approach - radial styloid fixation - radial column - radial styloid plate


Publication History

Received: 26 September 2021

Accepted: 08 March 2022

Article published online:
06 June 2022

© 2022. Thieme. All rights reserved.

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