OBJECTIVES:: Determining the rate of specific adverse events after volar plating performed for distal radius fractures. DESIGN:: Retrospective. SETTING:: University level I trauma center. PATIENTS:: We searched the electronic database of all surgical procedures performed in our department using the following keywords: distal radius fracture, wrist fracture, and plate fixation. We identified 315 patients, 12 of whom were lost at follow-up. INTERVENTION:: Volar plate fixation for the treatment of distal radius fractures. MAIN OUTCOME MEASUREMENTS:: At an average follow-up of 5 years, 303 patients were evaluated through medical records and clinical and radiographic assessment for specific adverse events after volar plate fixation. RESULTS:: Adverse events were observed in 18 patients (5.9%). Implant-related adverse events, including tendon impairments, intra-articular screws, and screw loosening, were observed in 15 patients (5.0%). Extensor tendon impairments were represented by 5 cases of extensor tenosynovitis and 3 cases of rupture of the extensor pollicis longus due to screws protruding dorsally. Flexor impairments were represented by 2 cases of tenosynovitis and 2 cases of flexor pollicis longus rupture. Screw penetration into the radioulnar joint was observed in 1 case. Loss of reduction was identified in 3 cases. One patient had a deep postoperative infection treated with operative debridement. One patient experienced injury to the median nerve during routine implant removal unrelated to tendon issues. CONCLUSIONS:: The majority of adverse events after volar plate fixation were due to technical errors in implant placement. In our cohort, tendon impairments were the most frequently observed; among these, extensor tendon impairments were the most represented (50% of all adverse events). All 12 tendon-related adverse events were due to technical shortcomings with implant placement. LEVEL OF EVIDENCE:: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. © 2013 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

Volar plate fixation for the treatment of distal radius fractures: Analysis of adverse events / Tarallo, Luigi; Mugnai, Raffaele; Zambianchi, Francesco; Adani, Roberto; Catani, Fabio. - In: JOURNAL OF ORTHOPAEDIC TRAUMA. - ISSN 0890-5339. - 27:12(2013), pp. 740-745. [10.1097/BOT.0b013e3182913fc5]

Volar plate fixation for the treatment of distal radius fractures: Analysis of adverse events

Tarallo, Luigi;Mugnai, Raffaele;Zambianchi, Francesco;Adani, Roberto;Catani, Fabio
2013

Abstract

OBJECTIVES:: Determining the rate of specific adverse events after volar plating performed for distal radius fractures. DESIGN:: Retrospective. SETTING:: University level I trauma center. PATIENTS:: We searched the electronic database of all surgical procedures performed in our department using the following keywords: distal radius fracture, wrist fracture, and plate fixation. We identified 315 patients, 12 of whom were lost at follow-up. INTERVENTION:: Volar plate fixation for the treatment of distal radius fractures. MAIN OUTCOME MEASUREMENTS:: At an average follow-up of 5 years, 303 patients were evaluated through medical records and clinical and radiographic assessment for specific adverse events after volar plate fixation. RESULTS:: Adverse events were observed in 18 patients (5.9%). Implant-related adverse events, including tendon impairments, intra-articular screws, and screw loosening, were observed in 15 patients (5.0%). Extensor tendon impairments were represented by 5 cases of extensor tenosynovitis and 3 cases of rupture of the extensor pollicis longus due to screws protruding dorsally. Flexor impairments were represented by 2 cases of tenosynovitis and 2 cases of flexor pollicis longus rupture. Screw penetration into the radioulnar joint was observed in 1 case. Loss of reduction was identified in 3 cases. One patient had a deep postoperative infection treated with operative debridement. One patient experienced injury to the median nerve during routine implant removal unrelated to tendon issues. CONCLUSIONS:: The majority of adverse events after volar plate fixation were due to technical errors in implant placement. In our cohort, tendon impairments were the most frequently observed; among these, extensor tendon impairments were the most represented (50% of all adverse events). All 12 tendon-related adverse events were due to technical shortcomings with implant placement. LEVEL OF EVIDENCE:: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. © 2013 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
2013
27
12
740
745
Volar plate fixation for the treatment of distal radius fractures: Analysis of adverse events / Tarallo, Luigi; Mugnai, Raffaele; Zambianchi, Francesco; Adani, Roberto; Catani, Fabio. - In: JOURNAL OF ORTHOPAEDIC TRAUMA. - ISSN 0890-5339. - 27:12(2013), pp. 740-745. [10.1097/BOT.0b013e3182913fc5]
Tarallo, Luigi; Mugnai, Raffaele; Zambianchi, Francesco; Adani, Roberto; Catani, Fabio
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1156795
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