Bakker Adam J, Shin Alexander Y
Department of Orthopaedic Surgery, Division of Hand Surgery, Mayo Clinic, Rochester, MN.
Tech Hand Up Extrem Surg. 2014 Mar;18(1):56-60. doi: 10.1097/BTH.0000000000000038.
The volar lunate facet/volar marginal rim fragment of distal radius fractures is a challenging problem for current volar plating systems to adequately maintain internal fixation. Fragment-specific wireforms and other constructs can be used to capture these difficult fragments but are difficult to place and have limited resistance to bending and axial load. Fixed-angle volar plates have limited distal translation without increasing the risk of flexor tendon rupture. Failure to reduce and maintain reduction of these volar ulnar intra-articular distal marginal rim fractures result in disastrous volar carpal subluxation. We present an alternative surgical technique using a low-profile volar hook plate designed specifically to address this fragment. The first 6 cases are presented here with no observed surgical complications to date.
桡骨远端骨折的掌侧月骨小关节面/掌侧边缘骨折块，对于当前的掌侧钢板固定系统来说，要充分维持内固定是一个具有挑战性的问题。针对骨折块的特定钢丝形状及其他结构可用于固定这些棘手的骨折块，但放置困难，且抗弯曲和轴向负荷的能力有限。角度固定掌侧钢板在不增加屈肌腱断裂风险的情况下，远端平移受限。未能复位并维持这些掌侧尺侧关节内远端边缘骨折块的复位会导致灾难性的掌侧腕骨半脱位。我们提出一种替代手术技术，使用专门设计用于处理该骨折块的低轮廓掌侧钩钢板。本文介绍了前6例病例，迄今为止未观察到手术并发症。
