Surgical comfort and clinical outcomes of MIPO with an extra-short plate designed for distal radius fractures
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ORIGINAL ARTICLE
Surgical comfort and clinical outcomes of MIPO with an extra‑short plate designed for distal radius fractures Ghada Asmar1 · Jonathan Bellity1 · Marc‑Olivier Falcone1,2 Received: 24 May 2020 / Accepted: 10 September 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Objectives Volar locking plates (VLPs) are increasingly used for distal radius fractures (DRFs) with minimally invasive plate osteosynthesis (MIPO), but surgery learning curves could be long. The purpose of this study was to assess a new extra-short plate with two locking diaphyseal divergent screws, specifically designed for MIPO, preserving the pronator quadratus muscle. Materials and methods This retrospective study consisted of three phases: (i) the evaluation of surgical comfort with the incision size and the duration of 59 consecutive surgeries using the extra-short plate in DRFs; (ii) the verification of the implant ability to maintain radiographic indices compared immediately postoperatively and at consolidation. They included radial inclination (RI), volar tilt (VT) and ulnar variance (UV); (iii) the assessment of clinical outcomes at last follow-up through: pain measured on the visual analogue scale (VAS), QuickDASH score, patient-rated wrist evaluation (PRWE) score, grip strength, range of motion and complications. Results In the first phase: mean incision size was 32 mm, and mean operative time was 28.5 min. In the second phase, there was no statistical difference between the two measures of the indices studied. In the third phase, mean follow-up time was 14.2 months, VAS score was 1.1, QuickDASH score was 11.4/100, and PRWE score was 9.5/100. Flexion was 91%, extension was 94%, and grip strength was 86% compared to the contralateral side. Conclusion The surgical comfort may be related to short operative time and incision. The implant allowed maintaining the radiographic indices without secondary displacement. Functional clinical outcomes were satisfactory. This extra-short plate design belongs to a novel generation of VLPs. Keywords Distal radius · Fracture · Mini-invasive approach · Extra-short locking plate · Pronator quadratus · Clinical outcomes
Introduction Minimally invasive approaches with plating are a recent trend, especially in displaced distal radius fractures (DRFs). According to Obert et al. [1], although DRFs are frequent in adults, the level of evidence supporting a specific surgical technique is low. Nevertheless, arguments are emerging to support the use of the less invasive approaches. These * Marc‑Olivier Falcone [email protected] 1
Ramsay Générale de Santé - Capio - Hôpital Privé Paul d’Egine, 4 avenue Marx Dormoy, 94500 Champigny‑Sur‑Marne, France
Clinique Internationale du Parc Monceau, 21 rue de Chazelles, 75017 Paris, France
2
arguments favour volar locking plates (VLPs) over percutaneous pinning in dorsally displaced DRFs [2, 3]. In the presence of a multitude of minimally invasive approaches for the distal radius, and the lack of a clear definit
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