[The treatment of dorsally displaced intra-articular fractures of the distal radius via palmar approach].
OBJECTIVE
To treat dorsally displaced intra-articular fractures of the distal radius, and to assess the integrity of radiocarpal joint and the reliability of stable fixation fracture.


METHODS
Sixty-three cases (65 sides) patients with dorsally displaced intra-articular fractures of the distal radius were performed operatively with the open reduction and internal fixation via palmar approach between August 2003 and May 2008. The series included 20 males (21 sides) and 43 females (44 sides). The mean age of patients was 52.4 years ranging from 18 to 82 years. According to the Frykman classification, 6 sides were of type III, 8 of type IV, 5 of type V, 4 of type VI, 13 of type VII and 29 of type VIII. With the exception of the radiocarpal arthrography and the standard antero-posterior and lateral views of the wrist joint, two new tangential antero-posterior and lateral views of the wrist joint were intraoperatively described so as to observe the relation of the distal screws with the articular surface.


RESULTS
The 53 cases (54 sides) of the 63 cases (65 sides) were followed up, and the follow-up time was averagely 16.4 months ranging from 4 to 47 months. According to Gartland and Werley criteria, 32 sides were rated as excellent (59.3%), 14 sides as good (25.9%), 7 fair (13.0%) and 1 poor (1.8%), and the excellent-good rate was 85.2%. Observing the new tangential antero-posterior and lateral views of the wrist joint, it showed that screws appeared penetrating into the radiocarpal joint in 26 of the 42 sides by standard antero-posterior view and in 31 of the 42 sides by standard lateral view.


CONCLUSIONS
This palmar approach represents a simple and valuable treatment methodology for the most frequent types of unstable fractures of the distal radius in young and elderly patients.
Department of Orthopaedic Surgery, Beijing Charity Hospital, China Rehabilitation Research Center, Rehabilitation School of Capital Medical University, Beijing, China. rogerstraits@sina.com
Tao
T
Tang
Jian-Pu
JP
Feng
Si-Hai
SH
Liu
Zhi-Gang
ZG
Cui
Fei
F
Wang
Xiao-Qiang
XQ
Han
Xin-Zuo
XZ
Han
Ke-Min
KM
Liu
An-Qing
AQ
Wang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D057072:Intra-Articular Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011885:Radius Fractures / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult