Soussou Thomas S, Chan Jason, Congiusta Dominick, Yedikian Teren, Ogilvie Daniella, Vosbikian Michael, Ahmed Irfan
Rutgers New Jersey Medical School, Newark, USA.
Hand (N Y). 2025 Mar 27:15589447251326201. doi: 10.1177/15589447251326201.
The purpose of this study was to compare outcomes of distal radius fractures with a volar ulnar corner (VUC) component treated with standard volar plating or by specific VUC fixation. This study investigated outcomes, radiographic measures, and specialty-based preference associated with surgical treatment of VUC injuries using VUC-specific fixation versus nonspecific VUC fixation.
We retrospectively analyzed outcomes for 39 patients with a distal radius fracture with VUC component at a level-1 trauma center over 10 years, 2011-2021. Patients underwent either VUC-specific fixation with implants such as a volar rim plate, or with a standard volar plate. The primary outcome of this study was fixation failure and need for revision. Secondary outcomes included complication rate, radiographic alignment, and differences in fixation based on fellowship training.
Sixteen of the 39 patients studied had undergone VUC-specific fixation, with a significantly higher rate of use of VUC-specific fixation in fellowship trained hand surgeons compared with fellowship-trained trauma surgeons. There was no significant difference in loss of reduction, revision surgery, or complications. Radiographic measures were statistically similar between both groups postoperatively. Trauma trained surgeons had a significantly increased postoperative radial inclination versus hand-trained surgeons.
This study suggests that not all VUC injuries require specific VUC fixation, and we may be overtreating distal radius fractures that have a VUC component. Fellowship-trained hand surgeons are more likely to employ VUC-specific fixation methods. Additional studies are warranted to determine whether other considerations such as dynamic testing intraoperatively are worthwhile.
本研究的目的是比较采用标准掌侧钢板或特定掌侧尺骨角（VUC）固定治疗的伴有掌侧尺骨角（VUC）成分的桡骨远端骨折的疗效。本研究调查了使用VUC特异性固定与非特异性VUC固定手术治疗VUC损伤的疗效、影像学测量结果以及基于专业的偏好。
我们回顾性分析了2011年至2021年10年间在一级创伤中心的39例伴有VUC成分的桡骨远端骨折患者的治疗结果。患者接受了掌侧边缘钢板等植入物的VUC特异性固定或标准掌侧钢板固定。本研究的主要结局是固定失败和翻修需求。次要结局包括并发症发生率、影像学对线情况以及基于专科培训的固定差异。
在研究的39例患者中，16例接受了VUC特异性固定，与接受专科培训的创伤外科医生相比，接受专科培训的手外科医生使用VUC特异性固定的比例显著更高。复位丢失、翻修手术或并发症方面无显著差异。两组术后的影像学测量结果在统计学上相似。与手外科培训的医生相比，创伤外科培训的医生术后桡骨倾斜度显著增加。
本研究表明，并非所有VUC损伤都需要特异性VUC固定，我们可能对伴有VUC成分的桡骨远端骨折进行了过度治疗。接受专科培训的手外科医生更有可能采用VUC特异性固定方法。有必要进行更多研究以确定术中动态测试等其他考虑因素是否值得。
