Cargando…
Biomechanics of Subcutaneous Locked Plating Versus Burke Plate and External Fixator for Comminuted Distal Radius Fractures
Background External fixators that span the wrist have been the historical norm in treating distal radius fractures. We have modified a dorsal distraction approach by using a subcutaneously applied locked bridge plate through two small incisions superficial to the extensor tendons and outside the ext...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10275508/ https://www.ncbi.nlm.nih.gov/pubmed/37332475 http://dx.doi.org/10.7759/cureus.39142 |
_version_ | 1785059886441168896 |
---|---|
author | Fleifel, Dominik Pytiak, Andrew V Jin, Xin Cizmic, Zlatan Vaidya, Rahul |
author_facet | Fleifel, Dominik Pytiak, Andrew V Jin, Xin Cizmic, Zlatan Vaidya, Rahul |
author_sort | Fleifel, Dominik |
collection | PubMed |
description | Background External fixators that span the wrist have been the historical norm in treating distal radius fractures. We have modified a dorsal distraction approach by using a subcutaneously applied locked bridge plate through two small incisions superficial to the extensor tendons and outside the extensor compartment. The purpose of this study was to biomechanically evaluate this modified method of fixation for comminuted distal radius fractures in comparison with two established constructs. Methods Matched cadaver specimens were used to model an AO Type 23-C3 distal radius fracture. Biochemical testing for stiffness during axial compressive loading was done on three constructs: a conventional Burke distraction plate, the subcutaneous internal fixation plating technique, and an external fixator. All specimens were cyclically loaded for 3000 cycles and then retested. Results The modified construct was found to be stiffer than the external fixator (p=0.013). When compared to the Burke plate, the modified construct was significantly less stiff before axial cycling (p=0.025). However, the difference was not maintained after cycling, and the post-axial loading stiffness difference was non-significant (p=0.456). Conclusion Our data demonstrate the biomechanical integrity of the subcutaneous plating technique for the fixation of comminuted distal radius fractures. It is stiffer than an external fixator and has the theoretical advantage of avoiding pin-tract infections. In addition, it is subcutaneous and not a cumbersome external construct. Our construct is minimally invasive, and it does not violate the dorsal extensor compartments. This allows for finger movement even while the construct is in place. |
format | Online Article Text |
id | pubmed-10275508 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-102755082023-06-17 Biomechanics of Subcutaneous Locked Plating Versus Burke Plate and External Fixator for Comminuted Distal Radius Fractures Fleifel, Dominik Pytiak, Andrew V Jin, Xin Cizmic, Zlatan Vaidya, Rahul Cureus Orthopedics Background External fixators that span the wrist have been the historical norm in treating distal radius fractures. We have modified a dorsal distraction approach by using a subcutaneously applied locked bridge plate through two small incisions superficial to the extensor tendons and outside the extensor compartment. The purpose of this study was to biomechanically evaluate this modified method of fixation for comminuted distal radius fractures in comparison with two established constructs. Methods Matched cadaver specimens were used to model an AO Type 23-C3 distal radius fracture. Biochemical testing for stiffness during axial compressive loading was done on three constructs: a conventional Burke distraction plate, the subcutaneous internal fixation plating technique, and an external fixator. All specimens were cyclically loaded for 3000 cycles and then retested. Results The modified construct was found to be stiffer than the external fixator (p=0.013). When compared to the Burke plate, the modified construct was significantly less stiff before axial cycling (p=0.025). However, the difference was not maintained after cycling, and the post-axial loading stiffness difference was non-significant (p=0.456). Conclusion Our data demonstrate the biomechanical integrity of the subcutaneous plating technique for the fixation of comminuted distal radius fractures. It is stiffer than an external fixator and has the theoretical advantage of avoiding pin-tract infections. In addition, it is subcutaneous and not a cumbersome external construct. Our construct is minimally invasive, and it does not violate the dorsal extensor compartments. This allows for finger movement even while the construct is in place. Cureus 2023-05-17 /pmc/articles/PMC10275508/ /pubmed/37332475 http://dx.doi.org/10.7759/cureus.39142 Text en Copyright © 2023, Fleifel et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Orthopedics Fleifel, Dominik Pytiak, Andrew V Jin, Xin Cizmic, Zlatan Vaidya, Rahul Biomechanics of Subcutaneous Locked Plating Versus Burke Plate and External Fixator for Comminuted Distal Radius Fractures |
title | Biomechanics of Subcutaneous Locked Plating Versus Burke Plate and External Fixator for Comminuted Distal Radius Fractures |
title_full | Biomechanics of Subcutaneous Locked Plating Versus Burke Plate and External Fixator for Comminuted Distal Radius Fractures |
title_fullStr | Biomechanics of Subcutaneous Locked Plating Versus Burke Plate and External Fixator for Comminuted Distal Radius Fractures |
title_full_unstemmed | Biomechanics of Subcutaneous Locked Plating Versus Burke Plate and External Fixator for Comminuted Distal Radius Fractures |
title_short | Biomechanics of Subcutaneous Locked Plating Versus Burke Plate and External Fixator for Comminuted Distal Radius Fractures |
title_sort | biomechanics of subcutaneous locked plating versus burke plate and external fixator for comminuted distal radius fractures |
topic | Orthopedics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10275508/ https://www.ncbi.nlm.nih.gov/pubmed/37332475 http://dx.doi.org/10.7759/cureus.39142 |
work_keys_str_mv | AT fleifeldominik biomechanicsofsubcutaneouslockedplatingversusburkeplateandexternalfixatorforcomminuteddistalradiusfractures AT pytiakandrewv biomechanicsofsubcutaneouslockedplatingversusburkeplateandexternalfixatorforcomminuteddistalradiusfractures AT jinxin biomechanicsofsubcutaneouslockedplatingversusburkeplateandexternalfixatorforcomminuteddistalradiusfractures AT cizmiczlatan biomechanicsofsubcutaneouslockedplatingversusburkeplateandexternalfixatorforcomminuteddistalradiusfractures AT vaidyarahul biomechanicsofsubcutaneouslockedplatingversusburkeplateandexternalfixatorforcomminuteddistalradiusfractures |