Asmar Ghada, Bellity Jonathan, Falcone Marc-Olivier
Ramsay Générale de Santé - Capio - Hôpital Privé Paul d'Egine, 4 avenue Marx Dormoy, 94500, Champigny-Sur-Marne, France.
Clinique Internationale du Parc Monceau, 21 rue de Chazelles, 75017, Paris, France.
Eur J Orthop Surg Traumatol. 2021 Apr;31(3):481-490. doi: 10.1007/s00590-020-02791-3. Epub 2020 Sep 21.
Volar locking plates (VLPs) are increasingly used for distal radius fractures (DRFs) with minimally invasive plate osteosynthesis (MIPO), but surgery learning curves could be long. The purpose of this study was to assess a new extra-short plate with two locking diaphyseal divergent screws, specifically designed for MIPO, preserving the pronator quadratus muscle.
This retrospective study consisted of three phases: (i) the evaluation of surgical comfort with the incision size and the duration of 59 consecutive surgeries using the extra-short plate in DRFs; (ii) the verification of the implant ability to maintain radiographic indices compared immediately postoperatively and at consolidation. They included radial inclination (RI), volar tilt (VT) and ulnar variance (UV); (iii) the assessment of clinical outcomes at last follow-up through: pain measured on the visual analogue scale (VAS), QuickDASH score, patient-rated wrist evaluation (PRWE) score, grip strength, range of motion and complications.
In the first phase: mean incision size was 32 mm, and mean operative time was 28.5 min. In the second phase, there was no statistical difference between the two measures of the indices studied. In the third phase, mean follow-up time was 14.2 months, VAS score was 1.1, QuickDASH score was 11.4/100, and PRWE score was 9.5/100. Flexion was 91%, extension was 94%, and grip strength was 86% compared to the contralateral side.
The surgical comfort may be related to short operative time and incision. The implant allowed maintaining the radiographic indices without secondary displacement. Functional clinical outcomes were satisfactory. This extra-short plate design belongs to a novel generation of VLPs.
掌侧锁定钢板（VLP）越来越多地用于采用微创钢板接骨术（MIPO）治疗的桡骨远端骨折（DRF），但手术学习曲线可能较长。本研究的目的是评估一种新型超短钢板，其带有两个锁定骨干发散螺钉，专为MIPO设计，可保留旋前方肌。
本回顾性研究包括三个阶段：（i）通过对59例连续使用超短钢板治疗DRF的手术切口大小和手术时长进行评估，以评价手术舒适度；（ii）验证植入物在术后即刻和骨折愈合时维持影像学指标的能力。这些指标包括桡骨倾斜度（RI）、掌侧倾斜度（VT）和尺骨变异（UV）；（iii）通过以下指标评估末次随访时的临床结果：视觉模拟量表（VAS）测量的疼痛、QuickDASH评分、患者自评腕关节评估（PRWE）评分、握力、活动范围和并发症。
在第一阶段：平均切口大小为32 mm，平均手术时间为28.5分钟。在第二阶段，所研究指标的两次测量之间无统计学差异。在第三阶段，平均随访时间为14.2个月，VAS评分为1.1，QuickDASH评分为11.4/100，PRWE评分为9.5/100。与对侧相比，屈曲为91%，伸展为94%，握力为86%。
手术舒适度可能与手术时间短和切口小有关。该植入物能够维持影像学指标且无二次移位。功能临床结果令人满意。这种超短钢板设计属于新一代的VLP。
