title: Distal radius fractures-Design of locking mechanism in plate system and recent surgical procedures.
abstract: Recently, many studies have emphasized the importance of the comprehension of detailed functional anatomy of the distal forearm and wrist joint, and their biomechanics. A significant contribution which yields good functional outcomes of surgical treatment was the development of the locking plate technology; this technology has facilitated the improvement of the surgical technique for the fixation of fractures. This article reviews the locking mechanism and design of the fixation screws and plate, and the details of the surgical technique including the double-tired subchondral support procedure as it is applied to common fractures. Arthroscopic-assisted surgical procedures can be used to reduce the intra-articular fracture fragments after realignment of the distal radius with the locking plate. This technique is also useful at the time of fixation to assess soft tissue injury. The combination of arthroscopic-assisted reduction and locking plate fixation is now indicated for AO type C2 and C3 intra-articular comminuted fractures.
authors.affiliation: Department of Orthopaedic Surgery, Showa University School of Medicine, Japan. Electronic address: katsu@med.showa-u.ac.jp.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Inagaki
authors.affiliation: Department of Orthopaedic Surgery, Showa University Northern Yokohama Hospital, Japan.
authors.forename: Keikichi
authors.initials: K
authors.lastname: Kawasaki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000379:methods; D001860:Bone Plates; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D016268:Internal Fixators; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D007593:Joint Instability / Q000517:prevention & control; D008297:Male; D010024:Osteoporosis / Q000150:complications / Q000000981:diagnostic imaging; D011379:Prognosis; D011859:Radiography / Q000379:methods; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology*; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*