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Effectiveness of Percutaneous Pinning of Acute Partial Scapholunate Injury during Volar Locking Plating for Distal Radius Fractures: A Comparative Study of Pinning and Conservative Treatment

BACKGROUD: We hypothesized that concurrent temporary fixation of scapholunate ligament (SL) injury during volar locking plate (VLP) fixation of distal radius fractures (DRFs) would improve restoration outcomes based on both radiological and clinical results. Here, we performed a prospective, compara...

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Autores principales: Cha, Soo Min, Shin, Hyun Dae, Lee, Seung Hoo, Ahn, Byung Kuk
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Orthopaedic Association 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8173243/
https://www.ncbi.nlm.nih.gov/pubmed/34094017
http://dx.doi.org/10.4055/cios20164
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author Cha, Soo Min
Shin, Hyun Dae
Lee, Seung Hoo
Ahn, Byung Kuk
author_facet Cha, Soo Min
Shin, Hyun Dae
Lee, Seung Hoo
Ahn, Byung Kuk
author_sort Cha, Soo Min
collection PubMed
description BACKGROUD: We hypothesized that concurrent temporary fixation of scapholunate ligament (SL) injury during volar locking plate (VLP) fixation of distal radius fractures (DRFs) would improve restoration outcomes based on both radiological and clinical results. Here, we performed a prospective, comparative study investigating the effectiveness of temporary percutaneous reduction/pinning during VLP fixation in DRFs. METHODS: The first 43 consecutive SL injuries were treated concurrently after VLP fixation by closed pinning (group 1); the next 36 consecutive injuries were treated nonoperatively (group 2). Patients were followed up for at least 5 years after treatment. Basic demographic data, radiological measurements, arthroscopic findings of SL injury, and other clinical outcomes were evaluated. RESULTS: The mean follow-up period was 7.2 years. No significant differences in basic demographic data were evident between groups. Fracture patterns were not distinctively different between groups. The initial scapholunate angle measured immediately after surgery was 23° ± 3° in group 1 and 38° ± 13° in group 2, indicating a significantly hyperextended scaphoid position in group 1. The final scapholunate angles were also significantly different between groups although the final angle in group 2 (58° ± 11°) was within normal limits. Final visual analog scale scores, Disabilities of the Arm, Shoulder and Hand scores, Gartland and Werley system scores, and wrist motions were not different between groups; however, grip strength at the time of final follow-up was closer to that of the contralateral uninjured wrist in group 1. Arthrosis was less advanced in group 1. CONCLUSIONS: Temporary fixation for SL injury with a DRF can be an effective option for the maintenance of scapholunate angle. The non-fixed group exhibited a more pronounced collapse of the scapholunate angle although the angle was still within normal limits, and clinical outcomes were similar between groups regardless of the fixation status.
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spelling pubmed-81732432021-06-04 Effectiveness of Percutaneous Pinning of Acute Partial Scapholunate Injury during Volar Locking Plating for Distal Radius Fractures: A Comparative Study of Pinning and Conservative Treatment Cha, Soo Min Shin, Hyun Dae Lee, Seung Hoo Ahn, Byung Kuk Clin Orthop Surg Original Article BACKGROUD: We hypothesized that concurrent temporary fixation of scapholunate ligament (SL) injury during volar locking plate (VLP) fixation of distal radius fractures (DRFs) would improve restoration outcomes based on both radiological and clinical results. Here, we performed a prospective, comparative study investigating the effectiveness of temporary percutaneous reduction/pinning during VLP fixation in DRFs. METHODS: The first 43 consecutive SL injuries were treated concurrently after VLP fixation by closed pinning (group 1); the next 36 consecutive injuries were treated nonoperatively (group 2). Patients were followed up for at least 5 years after treatment. Basic demographic data, radiological measurements, arthroscopic findings of SL injury, and other clinical outcomes were evaluated. RESULTS: The mean follow-up period was 7.2 years. No significant differences in basic demographic data were evident between groups. Fracture patterns were not distinctively different between groups. The initial scapholunate angle measured immediately after surgery was 23° ± 3° in group 1 and 38° ± 13° in group 2, indicating a significantly hyperextended scaphoid position in group 1. The final scapholunate angles were also significantly different between groups although the final angle in group 2 (58° ± 11°) was within normal limits. Final visual analog scale scores, Disabilities of the Arm, Shoulder and Hand scores, Gartland and Werley system scores, and wrist motions were not different between groups; however, grip strength at the time of final follow-up was closer to that of the contralateral uninjured wrist in group 1. Arthrosis was less advanced in group 1. CONCLUSIONS: Temporary fixation for SL injury with a DRF can be an effective option for the maintenance of scapholunate angle. The non-fixed group exhibited a more pronounced collapse of the scapholunate angle although the angle was still within normal limits, and clinical outcomes were similar between groups regardless of the fixation status. The Korean Orthopaedic Association 2021-06 2021-04-01 /pmc/articles/PMC8173243/ /pubmed/34094017 http://dx.doi.org/10.4055/cios20164 Text en Copyright © 2021 by The Korean Orthopaedic Association https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Cha, Soo Min
Shin, Hyun Dae
Lee, Seung Hoo
Ahn, Byung Kuk
Effectiveness of Percutaneous Pinning of Acute Partial Scapholunate Injury during Volar Locking Plating for Distal Radius Fractures: A Comparative Study of Pinning and Conservative Treatment
title Effectiveness of Percutaneous Pinning of Acute Partial Scapholunate Injury during Volar Locking Plating for Distal Radius Fractures: A Comparative Study of Pinning and Conservative Treatment
title_full Effectiveness of Percutaneous Pinning of Acute Partial Scapholunate Injury during Volar Locking Plating for Distal Radius Fractures: A Comparative Study of Pinning and Conservative Treatment
title_fullStr Effectiveness of Percutaneous Pinning of Acute Partial Scapholunate Injury during Volar Locking Plating for Distal Radius Fractures: A Comparative Study of Pinning and Conservative Treatment
title_full_unstemmed Effectiveness of Percutaneous Pinning of Acute Partial Scapholunate Injury during Volar Locking Plating for Distal Radius Fractures: A Comparative Study of Pinning and Conservative Treatment
title_short Effectiveness of Percutaneous Pinning of Acute Partial Scapholunate Injury during Volar Locking Plating for Distal Radius Fractures: A Comparative Study of Pinning and Conservative Treatment
title_sort effectiveness of percutaneous pinning of acute partial scapholunate injury during volar locking plating for distal radius fractures: a comparative study of pinning and conservative treatment
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8173243/
https://www.ncbi.nlm.nih.gov/pubmed/34094017
http://dx.doi.org/10.4055/cios20164
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