Document Detail


Precontoured fixed-angle volar distal radius plates: a comparison of anatomic fit.
MedLine Citation:
PMID:  18762111     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To compare distal radius volar fixed-angle plates for anatomic fit. METHODS: Twenty embalmed radii were stripped of soft tissues. The volar lip (watershed line) on the volar distal radius served as a reference line. Seven volar fixed-angle plates were tested (Acumed Acu-loc Standard, Hand Innovations DVRAW and DVRAN, Synthes Juxta-articular [JA], Synthes Extra-articular [EA], Trimed Volar Bearing, Zimmer Volar Lateral Column). Four parameters of anatomic fit were studied: (1) site of best fit; (2) percent plate contact; (3) pin-subchondral bone distance; and (4) extraosseous penetrations. The Wilcoxon signed rank test and Pearson's correlation coefficient were used to compare interobserver plate placement. A Kruskal-Wallis analysis of variance was used to compare percent plate contact and pin-subchondral bone distance across all plates. The Bonferroni correction for multiple comparisons was used to compare pin-subchondral bone distances for all possible plate combinations. RESULTS: There was no difference between observers for plate placement. Each plate had a specific site of best fit, and the 7 plates varied widely in best fit location. Percent contact (range, 3% to 6%) between plates was significantly different. Pin-subchondral bone distance across all plates was significantly different. Analysis of all possible plate combinations showed that the Synthes EA pin-subchondral bone distances were significantly different than those of all plates except Zimmer. Amongst the 140 plate insertions, the radiocarpal joint was penetrated in 17, the styloid in 7, (with 6 associated with the DVRAW plate), and the distal radioulnar joint in 9 (all associated with the DVRAW plate). CONCLUSIONS: There was considerable variation in ideal plate location among the 7 plates tested. Total contact was minimal for all plates tested. The Synthes EA pin-subchondral bone distance was significantly greater than those of other plates tested. Joint penetration was relatively common, necessitating use of fluoroscopy and proper plate width.
Authors:
Jonathan E Buzzell; Douglas R Weikert; Jeffry T Watson; Donald H Lee
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of hand surgery     Volume:  33     ISSN:  1531-6564     ISO Abbreviation:  J Hand Surg Am     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-02     Completed Date:  2009-01-30     Revised Date:  2009-06-08    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1144-52     Citation Subset:  IM    
Affiliation:
Vanderbilt Orthopaedic Institute, Hand and Upper Extremity Center, Nashville, TN 37232-8828, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Bone Plates*
Cadaver
Female
Fracture Fixation, Internal / instrumentation*
Humans
Male
Radius / anatomy & histology*
Comments/Corrections
Comment In:
J Hand Surg Am. 2009 Feb;34(2):365-6; author reply 366   [PMID:  19181243 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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