Comparison of radiographic and functional results of die-punch fracture of distal radius between volar locking plating (
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(2019) 14:373
RESEARCH ARTICLE
Open Access
Comparison of radiographic and functional results of die-punch fracture of distal radius between volar locking plating (VLP) and external fixation (EF) Yanqing Zhou1,2†, Yanbin Zhu3†, Xiong Zhang1,2, Dehu Tian1,2 and Bing Zhang1,2*
Abstract Purpose: The aim of this study is to investigate the radiographic and functional results of die-punch fracture of distal radius treated by volar locking plate (VLP) or external fixation (EF). Methods: Between January 2015 and June 2018, 87 patients who were treated with EF or VLP were included in this study. At postoperative 6 months and at least 12 months, radiographic and functional outcomes were evaluated, and compared between two groups using SPSS 21.0. Results: The follow-up period was 15.6 months in average, and at the mean 8.5 weeks bony union was achieved in all patients. At 6-month visit, patients in VLP group had significantly better wrist flexion (79.2° vs. 71.8°) and pronation (79.5° vs. 75.2°) than those in EF group, but the difference was non-significant at the last visit (> 12 months); as for other parameters, no significant differences were observed. No significant difference was found between both groups in term of volar tilt, radial inclination, radial height, ulnar variance, or Gartland–Werley score and DASH. The articular step-off was significantly greater in EF than VLP group (0.6 mm vs. 0.3 mm, p < 0.001). The overall incidence of complications seemed higher in EF group (25% vs. 14%), but not approaching to the statistical significance level. Conclusions: Patients with VLP fixation of die-punch fractures had better wrist flexion and pronation at 6-month visit and more favorable wrist joint congruence at the last visit, but ultimately their outcome was comparable with those treated by EF. Keywords: Die-punch fracture, Distal radius, Radiographic and functional outcome, Volar plate fixation, External fixation
Introduction Distal radius fracture is a very commonly seen injury, accounting for 7% to 25% of fractures in the populations of different age groups and 2.5% of all emergency department visits [1, 2]. In China alone, there were around 580,000 distal radius fractures during 2014 [3], and the incidence of distal radius fracture seems to be on the rise in China and abroad [4, 5].
* Correspondence: [email protected] † Yanqing Zhou and Yanbin Zhu contributed equally to this work. 1 Department of Hand Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, People’s Republic of China 2 Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei 050051, People’s Republic of China Full list of author information is available at the end of the article
Die-punch fracture of the distal radius was firstly described by Scheck in 1962 [6], as the dorsomedial fragments separated from the lunate fossa. Nowadays, this type of fracture is known as a special intra-articular fracture, mechanically a depression fracture of the lunate fossa caused by a vertical load through the lunat
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