No abstract available.
Metacarpophalangeal Joint* ; Palmar Plate*

Dislocations of the interphalangeal joint of the thumb are rather uncommon as a result of the inherent stability of the interphalangeal joint. Irreducible dislocations of these joint are rare. The authors report a case of irreducible dislocation of the interphalangeal joint of the thumb with interposed palmar plate, and reduced by open reduction.
Dislocations ; Joints ; Thumb ; Palmar Plate

Since the advent of volar locking plate, volar approach for internal fixation has become a major trend in the treatment for unstable distal radius fracture. However, dorsal approach is preferred for certain fracture pattern include AO type C3, dorsal Barton's fractures and concomitant intercarpal ligament injury, because it can afford excellent exposure of the articular surface. Although dorsal approach and plating technique has inherent disadvantages include extensor tendon irritation and rupture, improvements in implant design lead to decrease complication rate. Here, we provide overview of the pros and cons through historic perspective, indications, and surgical technique of the dorsal approach for the distal radius fracture.
Ligaments ; Radius Fractures* ; Rupture ; Tendons ; Palmar Plate

As volar plate fixation of distal radius fracture becomes more common, reports of ruptured extensor pollicis longus tendon by a protruding distal screw tip are also increasing steadily. Authors have experienced a rare case of ruptured extensor pollicis longus tendon at the prominent proximal screw of fixed volar plate for distal radius fracture, and we report it herein with a review of the literature.
Radius Fractures ; Radius ; Rupture ; Tendons ; Palmar Plate*

Traumatic dislocation of the metacarphophalangeal joint is a rare injury. Complex dislocation often require surgical procedure due to its anatomical characteristics. We report one case of surgically treated traumatic dislocation of the 5th metacarpophalangeal joint that was successfully reduced by volar open reduction without splitting the volar plate.
Dislocations ; Joints ; Metacarpophalangeal Joint ; Palmar Plate

OBJECTIVE: We determined the radiographic outcome of distal radius fractures with Acu-loc volar plate. METHODS: Forty-one patients were recruited between August 2009 and September 2010. There were 10 males and 31 females, with a mean age 61.2. Fractures were radiologically classification the Frykman. Fifteen fractures were group 8, eight were group 7, ten were group 6, four were group 5 and four were group 3. Distal part of the fractures was dorsally inclined in 37 wrists and inclined to volar side in four wrists. Lateral and anteroposterior radiographs taken after operated day, the fracture were compared with radiographs of the injured wrist and the differences in palmar tilt, ulnar variance; radial height; radial shift and radial inclination were measured. RESULTS: There was significant improvement in the measurements of radial height, radial inclination, volar tilt, ulnar variance and radial shift postoperatively. The radial height improved from an average of 8.5 mm (range, 3 to 15 mm) to 11.0 mm (range, 8 to 15 mm), the radial inclination improved from an average of 21.5 degree (range, 10 to 40 degree) to 28.1 degree (range, 19 to 44 degree), the palma tilt improved from an average of 12.9 degree (range, 6 to 22 degree) to 17.2 degree (range, 7 to 27 degree), the ulnar variance improved from an average of -2.3 mm (range, -6 to 4 mm) to 1 mm (range, -3 to 7 mm) and the radial shift improved from an average of 18.7 mm (range, 15 to 26 mm) to 17.3 mm (range, 12 to 21 mm). CONCLUSION: Acu-loc volar plate is a safe and effective device.
Female ; Humans ; Male ; Radius ; Radius Fractures ; Palmar Plate ; Wrist

As the, injury of flexor tendons has been rarely reported rarely after volar plate fixation in the distal radius fractures. Author experienced one case with delayed rupture of flexor pollicis longus and flexor digitorum profundus of index finger caused by anterior protrusion of volar plate. We also experienced another case with delayed rupture of flexor pollicis longus and wear on flexor digitorum profundus of index finger caused by volar plate placed distally to watershed line. Proper placement of volar plate and distal shape of the plate are important to prevent multiple tendon injury.
Fingers ; Radius ; Radius Fractures ; Rupture ; Tendon Injuries ; Tendons ; Palmar Plate

PURPOSE: To determine the relationship between the length of distal locking screws and diaphyseal screws in volar plate fixation of distal radius fractures. METHODS: A retrospective review was performed of 169 patients who underwent volar locking plate fixation for treatment of distal radius fractures. All patients received 2.4 mm LCP volar extra-articular distal radius plate (DePuySynthes). The length of the diaphyseal screw which was placed in the elongated hole was correlated with the length of a distal locking screw from radial most (D1) to ulnar most (D4). We also evaluated distal screw penetration of the dorsal cortex and plate removal rate. RESULTS: The length of the diaphyseal screw which was placed in the elongated hole strongly correlated with the length of a distal locking screw. Average D1 screw length was 2 mm longer than the diaphyseal screw, and average D2 screw length was 4 mm longer than the diaphyseal screw. D3 and D4 screw were 6 mm longer than the diaphyseal screw. Plate removal was necessary in 13 patients (8%) due to screw irritation. These patients had significantly longer screws than average. Flexor or extensor tendon ruptures did not occur in this cohort. CONCLUSION: The length of the distal locking screws can be estimated with the length of the diaphyseal screw. This information may help surgeons to select the adequate length of distal locking screws during volar plating of distal radius fractures.
Humans ; Radius ; Radius Fractures ; Retrospective Studies ; Rupture ; Tendons ; Palmar Plate

The extension type locked metacarpophalangeal joint of the little finger is an extremely rare condition characterized by loss of flexion with little or no loss of extension. The most common cause for locking is entrapment of a strap of the ruptured palmar plate. We treated a locked metacarpophalangeal joint of the little finger due to a hyperextension injury. The mechanism of locking was a torn part of the palmar ligament that forcefully rides across the prominence of the radial condyle of the metacarpal bone together with the accessory collateral ligament. These dislocated parts of the ligament formed a constricting bundle that prevented closed reduction. Locking was released successfully by an open reduction using the dorsal approach of the metacarpophalangeal joint without complication.
Collateral Ligaments ; Fingers* ; Ligaments ; Metacarpophalangeal Joint* ; Palmar Plate

BACKGROUNDWith a type C3 distal radius fracture it is extremely difficult to maintain the reduction and to restore congruity of the articular surface because the support for the volar and dorsal bone cortex has been lost. An external fixator crossing wrist in combination with Kirschner wire (K-wire) fixation was popularly used by most studies in recent years. But loss of reduction often occurred especially in the volar sides.

METHODSA total of 30 cases of type C3 distal radius fracture were treated by a volar buttress plate combined with a transarticular external fixator and other techniques such as K-wire fixation and bone grafting if necessary. The postoperative volar tilt angles, ulnar inclinations, radial heights, range of motion, grip strength and complications were recorded to assess the therapeutic effects.

RESULTSOf the 30 patients, 27 patients were followed up for 12 - 29 (mean 18) months and all fractures healed in 8 - 13 weeks after surgery (mean 10 weeks). The wrist function was excellent in 8 cases, good in 16 cases and fair in 3 cases according to the Sarmiento scoring system (modified by Stewart).

CONCLUSIONSFor type C3 comminuted fracture with severe volar and dorsal instability, fixation by volar buttress plate combined with transarticular external fixator should be adopted. Dorsal instability could be further stabilized by other techniques such as Kirschner wire fixation, and bone grafting.

Adult ; Bone Wires ; External Fixators ; Female ; Humans ; Male ; Middle Aged ; Palmar Plate ; surgery ; Radius Fractures ; surgery