VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University Medical Center, Redwood City.
Hand and Upper Extremity Surgery Department, Prof. Dr. "Carlos Ottolenghi Institute", Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Tech Hand Up Extrem Surg. 2024 Jun 1;28(2):115-121. doi: 10.1097/BTH.0000000000000463.
Distal radius fractures are one of the most common injuries seen globally with increasing use of use of volar plating for surgical treatment. Although it is common to directly visualize the articular surface for most other periarticular fractures, during volar plating of the distal radius the joint is typically not visualized. This is due to concern for carpal instability from disruption of the volar carpal ligaments. When direct visualization of the articular surface is deemed necessary, either to reduce articular fragments or to confirm the quality of reduction, current options include a separate dorsal arthrotomy or arthroscopic assistance. However, biomechanical evidence supports safely performing a volar capsulotomy to visualize the articular surface. We describe the Volar Intra-Articular Extended Window approach, which allows direct visualization of the articular surface through the volar approach to treat distal radius fractures.
桡骨远端骨折是全球最常见的骨折之一,随着掌侧钢板固定术在外科治疗中的应用越来越多,这种骨折也越来越常见。虽然对于大多数其他关节周围骨折,直接观察关节面是很常见的,但在桡骨远端掌侧钢板固定术中,通常无法观察到关节面。这是由于担心破坏掌侧腕骨韧带会导致腕骨不稳定。当需要直接观察关节面时,无论是为了复位关节面碎片还是为了确认复位质量,目前的选择包括单独的背侧关节切开术或关节镜辅助。然而,生物力学证据支持安全地进行掌侧囊切开术来观察关节面。我们描述了一种掌侧关节内扩展窗口入路,该入路通过掌侧入路可以直接观察关节面,从而治疗桡骨远端骨折。