Dondapati Ashwini, Pandian Haemanath, Mohideen Sheik, Pradeep E, Kumar K V Arun, Balamurugan P
Department of Orthopaedic Surgery, Chettinad Hospital and Research Institute, Kelambakkam, Tamil Nadu, India.
Department of Orthopaedic Surgery, Sree Balaji Medical College And Hospital , Chromepet, Chennai, Tamil Nadu 600044.
J Orthop Case Rep. 2025 May;15(5):269-273. doi: 10.13107/jocr.2025.v15.i05.5630.
A distal radius fracture is a common injury that affects people of all ages. However, there are various therapy approaches that are controversial. Casting with or without closed reduction has long been considered a feasible option for treating distal radius fractures; alternative options include K-wire fixation and ligamentotax are with external fixation. However, with limited function and impairments, the results are frequently poor. "Several studies have found that distal radius fractures treated with external fixation have good anatomical and functional outcomes, although there is a substantial risk of pin tract infection and nerve damage. Internal fixation and classic open reduction frequently result in severe soft tissue dissection and periosteal damage, which can cause infection, delayed union, and non-union. Fortunately, a new approach known as minimally invasive plate osteosynthesis (MIPO) has recently evolved, which can reduce soft tissue stripping and bone vascularity loss while improving fracture healing.
A prospective study of 20 patients with closed distal radius fractures was treated by the MIPO technique with a palmar locking plate between November 2022 and April 2023 and was followed up for 6 months.
There were 12 females and 8 males with an average age of 54.2 years. The average blood loss was around 52 ml approximately. 11 patients obtained excellent results, 7 cases had good results and 2 patients had moderate effects. The average disabilities of the arm, shoulder, and hand score after 6 months was about 10.2.
In conclusion, two small incisions to implant a palmar locking plate by MIPO for distal radius fractures give good functional results as soft tissue handling is better compared to the conventional method of plating. But further research also should be carried out to explore more suitable treatment for specific individuals.
桡骨远端骨折是一种常见损伤,影响各年龄段人群。然而,有多种治疗方法存在争议。长期以来,无论是否进行闭合复位,石膏固定一直被认为是治疗桡骨远端骨折的可行选择;其他选择包括克氏针固定和外固定架下的韧带整复术。然而,由于功能受限和损伤,结果往往不佳。“多项研究发现,尽管外固定治疗桡骨远端骨折存在针道感染和神经损伤的重大风险,但具有良好的解剖和功能结果。内固定和经典的切开复位经常导致严重的软组织剥离和骨膜损伤,这可能导致感染、延迟愈合和不愈合。幸运的是,一种称为微创钢板接骨术(MIPO)的新方法最近出现了,它可以减少软组织剥离和骨血运丧失,同时改善骨折愈合。
对20例闭合性桡骨远端骨折患者进行前瞻性研究,于2022年11月至2023年4月采用MIPO技术使用掌侧锁定钢板进行治疗,并随访6个月。
女性12例,男性8例,平均年龄54.2岁。平均失血量约为52毫升。11例患者获得优异结果,7例效果良好,2例患者效果中等。6个月后手臂、肩部和手部的平均功能障碍评分为10.2左右。
总之,通过MIPO技术经两个小切口植入掌侧锁定钢板治疗桡骨远端骨折,与传统钢板固定方法相比,软组织处理更好,功能结果良好。但还应开展进一步研究,为特定个体探索更合适的治疗方法。