title: Dorsal approach and internal fixation of impacted intra-articular distal radius fractures with 2.4 mm locking plates.
abstract: The treatment of impacted distal radius fractures is complex. Internal fixation by a dorsal approach with arthrotomy should be considered, particularly when the fractures are dorsally comminuted. This was a retrospective, observational study of 26 patients operated between 2008 and 2012 who were reviewed in September 2013. In the surgical procedure, a single dorsal incision was made over the distal radius and arthrotomy performed; the fracture site was stabilized with two 2.4mm locking plates. The average follow-up was 39months. All fractures were type 23C in the AO classification. All patients were assessed with the QuickDASH and Mayo Wrist scores. Total range of motion was 82% of the contralateral side. Grip strength was 30kg in average. The mean radial sagittal tilt was +6° postoperatively. No plate movement or intra-articular screws were present. Four patients developed symptomatic early osteoarthritis. Thirteen patients had the plate removed due to discomfort. No tendon ruptures were observed. The dorsal approach remains a treatment option for specific intra-articular fractures. It offers direct intra-articular congruency control, along with a stable buttress and locking fixation for early mobilization. Our results are comparable to those using other surgical techniques for this type of high-energy fracture.
authors.affiliation: Unité de chirurgie de la main et des nerfs périphériques, service d'orthopédie et traumatologie de l'appareil moteur, hôpital universitaire de Genève (HUG), rue Gabrielle-Perret-Gentil 4, 1205 Genève, Switzerland. Electronic address: Alexander.desmet@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: De Smet
authors.affiliation: Unité de chirurgie de la main et des nerfs périphériques, service d'orthopédie et traumatologie de l'appareil moteur, hôpital universitaire de Genève (HUG), rue Gabrielle-Perret-Gentil 4, 1205 Genève, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Lamouille
authors.affiliation: Unité de chirurgie de la main et des nerfs périphériques, service d'orthopédie et traumatologie de l'appareil moteur, hôpital universitaire de Genève (HUG), rue Gabrielle-Perret-Gentil 4, 1205 Genève, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Vostrel
authors.affiliation: Unité de chirurgie de la main et des nerfs périphériques, service d'orthopédie et traumatologie de l'appareil moteur, hôpital universitaire de Genève (HUG), rue Gabrielle-Perret-Gentil 4, 1205 Genève, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Loret
authors.affiliation: Unité de chirurgie de la main et des nerfs périphériques, service d'orthopédie et traumatologie de l'appareil moteur, hôpital universitaire de Genève (HUG), rue Gabrielle-Perret-Gentil 4, 1205 Genève, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Hoffmeyer
authors.affiliation: Unité de chirurgie de la main et des nerfs périphériques, service d'orthopédie et traumatologie de l'appareil moteur, hôpital universitaire de Genève (HUG), rue Gabrielle-Perret-Gentil 4, 1205 Genève, Switzerland.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Beaulieu
mesh_terms: D001860:Bone Plates / Q000706:statistics & numerical data; D020878:Device Removal / Q000706:statistics & numerical data; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000601:surgery; D018737:Hand Strength; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies
keywords: Abord postérieur; Articular impaction; Distal radius; Dorsal approach; Enfoncement articulaire; Extrémité distale du radius; Intra-articulaire; Intra-articular; ORIF; Ostéosynthèse