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Risk Factors for the Incidence of the Volar Lunate Facet Fragments in Distal Radius Fractures

Background  The volar lip of the distal radius is the key structure for wrist joint stability. Rigid fixation of the volar lunate facet (VLF) fragment is difficult because of its unique anatomy, and a high rate of postoperative displacement was demonstrated. Purposes  The aim of the study is to iden...

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Autores principales: Mitsuzawa, Sadaki, Takeuchi, Hisataka, Tsukamoto, Yoshihiro, Yamashita, Shinnosuke, Ota, Satoshi, Onishi, Eijiro, Yasuda, Tadashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical Publishers, Inc. 2023
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10411066/
https://www.ncbi.nlm.nih.gov/pubmed/37564612
http://dx.doi.org/10.1055/s-0042-1760125
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author Mitsuzawa, Sadaki
Takeuchi, Hisataka
Tsukamoto, Yoshihiro
Yamashita, Shinnosuke
Ota, Satoshi
Onishi, Eijiro
Yasuda, Tadashi
author_facet Mitsuzawa, Sadaki
Takeuchi, Hisataka
Tsukamoto, Yoshihiro
Yamashita, Shinnosuke
Ota, Satoshi
Onishi, Eijiro
Yasuda, Tadashi
author_sort Mitsuzawa, Sadaki
collection PubMed
description Background  The volar lip of the distal radius is the key structure for wrist joint stability. Rigid fixation of the volar lunate facet (VLF) fragment is difficult because of its unique anatomy, and a high rate of postoperative displacement was demonstrated. Purposes  The aim of the study is to identify risk factors for VLF in distal radius fractures (DRFs) and to reconsider the important point for primary fixation. Patients and Methods  One hundred fifty-five patients who underwent open reduction and internal fixation for an DRF were included and classified into one of the following two groups: VLF(+)or VLF(−). Demographic data, including age, sex, body mass index (BMI), laterality, trauma mechanism, and AO Foundation/Orthopaedic Trauma Association (AO/OTA) classification were recorded. Several parameters were investigated using wrist radiographs of the uninjured side and computed tomography scans of the injured side. Univariate and multivariate logistic regression analyses were performed to evaluate the risk factors for VLF. Results  There were 25 patients in the VLF(+) group and 130 patients in the VLF(−) group. The incidence of VLF was 16.1%. The VLF(+) group tended to have a higher BMI and higher energy trauma mechanism. The odds ratio for the sigmoid notch angle (SNA), volar tilt (VT), and lunate facet curvature radius (LFCR) were 0.84, 1.32, and 0.70, respectively, with multivariate analysis, which was significant. A smaller SNA, larger VT, and smaller LFCR are potential risk factors for VLF. Conclusion  Over-reduction of the VT at primary fixation should be avoided because it could place an excess burden on the VLF and cause subsequent postoperative fixation failure and volar carpal subluxation. Level of Evidence  IV
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spelling pubmed-104110662023-08-10 Risk Factors for the Incidence of the Volar Lunate Facet Fragments in Distal Radius Fractures Mitsuzawa, Sadaki Takeuchi, Hisataka Tsukamoto, Yoshihiro Yamashita, Shinnosuke Ota, Satoshi Onishi, Eijiro Yasuda, Tadashi J Wrist Surg Background  The volar lip of the distal radius is the key structure for wrist joint stability. Rigid fixation of the volar lunate facet (VLF) fragment is difficult because of its unique anatomy, and a high rate of postoperative displacement was demonstrated. Purposes  The aim of the study is to identify risk factors for VLF in distal radius fractures (DRFs) and to reconsider the important point for primary fixation. Patients and Methods  One hundred fifty-five patients who underwent open reduction and internal fixation for an DRF were included and classified into one of the following two groups: VLF(+)or VLF(−). Demographic data, including age, sex, body mass index (BMI), laterality, trauma mechanism, and AO Foundation/Orthopaedic Trauma Association (AO/OTA) classification were recorded. Several parameters were investigated using wrist radiographs of the uninjured side and computed tomography scans of the injured side. Univariate and multivariate logistic regression analyses were performed to evaluate the risk factors for VLF. Results  There were 25 patients in the VLF(+) group and 130 patients in the VLF(−) group. The incidence of VLF was 16.1%. The VLF(+) group tended to have a higher BMI and higher energy trauma mechanism. The odds ratio for the sigmoid notch angle (SNA), volar tilt (VT), and lunate facet curvature radius (LFCR) were 0.84, 1.32, and 0.70, respectively, with multivariate analysis, which was significant. A smaller SNA, larger VT, and smaller LFCR are potential risk factors for VLF. Conclusion  Over-reduction of the VT at primary fixation should be avoided because it could place an excess burden on the VLF and cause subsequent postoperative fixation failure and volar carpal subluxation. Level of Evidence  IV Thieme Medical Publishers, Inc. 2023-01-11 /pmc/articles/PMC10411066/ /pubmed/37564612 http://dx.doi.org/10.1055/s-0042-1760125 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Mitsuzawa, Sadaki
Takeuchi, Hisataka
Tsukamoto, Yoshihiro
Yamashita, Shinnosuke
Ota, Satoshi
Onishi, Eijiro
Yasuda, Tadashi
Risk Factors for the Incidence of the Volar Lunate Facet Fragments in Distal Radius Fractures
title Risk Factors for the Incidence of the Volar Lunate Facet Fragments in Distal Radius Fractures
title_full Risk Factors for the Incidence of the Volar Lunate Facet Fragments in Distal Radius Fractures
title_fullStr Risk Factors for the Incidence of the Volar Lunate Facet Fragments in Distal Radius Fractures
title_full_unstemmed Risk Factors for the Incidence of the Volar Lunate Facet Fragments in Distal Radius Fractures
title_short Risk Factors for the Incidence of the Volar Lunate Facet Fragments in Distal Radius Fractures
title_sort risk factors for the incidence of the volar lunate facet fragments in distal radius fractures
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10411066/
https://www.ncbi.nlm.nih.gov/pubmed/37564612
http://dx.doi.org/10.1055/s-0042-1760125
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